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World J Gastroenterol. Dec 28, 2013; 19(48): 9294-9306
Published online Dec 28, 2013. doi: 10.3748/wjg.v19.i48.9294
Published online Dec 28, 2013. doi: 10.3748/wjg.v19.i48.9294
Hepatitis B virus subgenotype A1 predominates in liver disease patients from Kerala, India
Deepak Gopalakrishnan, Mark Keyter, Anna Kramvis, Hepatitis Virus Diversity Research Programme, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Johannesburg 2193, South Africa
Deepak Gopalakrishnan, KR Vinayakumar, Charles Panackel, Arun T Korah, Ramesh Nair, Department of Gastroenterology, Medical College Trivandrum 695011, India
Kotacherry Trivikrama Shenoy, Kondarappassery Balakumaran Leena, Population Health and Research Institute, Trivandrum 695011, India
Lakshmikanthan Thayumanavan, Government Rajaji Hospital, Madurai Medical College, Madurai 625002, India
Varghese Thomas, Department of Gastroenterology, Calicut Medical College, PO Calicut 673008, India
Author contributions: Gopalakrishnan D and Keyter M contributed equally to the study; Gopalakrishnan D, Shenoy KT and Kramvis A conceived the study; Gopalakrishnan D, Shenoy KT, Leena KB, Thayumanavan L, Thomas V, Vinayakumar KR, Panackel C, Korah AT and Nair R collected the clinical data; Gopalakrishnan D, Keyter M and Kramvis A conceived and designed the laboratory experiments; Kramvis A contributed reagents, materials and analysis tools; Gopalakrishnan D and Keyter M performed the experiments; Gopalakrishnan D, Keyter M and Kramvis A analyzed and interpreted the data, and wrote the paper.
Supported by The National Research Foundation of South Africa, NRF, GUN 65530 (to Kramvis A) and the Cancer Association of South Africa; postdoctoral funding from the NRF, GUN 75055 and the University of the Witwatersrand (to Gopalakrishnan D); bursaries from the University of the Witwatersrand, the Poliomyelitis Research Foundation and the Ernst and Ethel Eriksen Trust (to Keyter M)
Correspondence to: Anna Kramvis, Professor, Hepatitis Virus Diversity Research Programme, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg 2193, South Africa. anna.kramvis@wits.ac.za
Telephone: +27-11-4883100 Fax: +27-86-5296806
Received: May 16, 2013
Revised: June 20, 2013
Accepted: July 17, 2013
Published online: December 28, 2013
Revised: June 20, 2013
Accepted: July 17, 2013
Published online: December 28, 2013
Core Tip
Core tip: This study shows the predominance of subgenotype A1 in liver disease patients in Kerala, and its high prevalence in hepatocellular carcinoma (HCC) patients. Subgenotype A1 could be more hepatocarcinogenic and HCC could develop at an earlier age, regardless of host ethnicity. The S open reading frame of subgenotype A1 isolates from Kerala clustered separately within the ‘‘Asian’’ cluster and encoded distinct subgenotype A1 amino acids. A higher frequency of G1862T was detected compared with subgenotype A1 isolates from other geographical regions. This is the first time that preS deletion mutants have been described in Indian HCC patients.