Received: 8 December 2017
Accepted: 25 December 2017
What is changed in HBV molecular epidemiology in Italy?
Alessandra L. Presti
Department of Biomedical and Clinical
Sciences L. Sacco, University of Milan,
Department of Mental Health and Public
Medicine, Section of Infectious Diseases,
University of Campania Luigi Vanvitelli,
Department of Infectious, Parasitic, and
Immune-Mediated Diseases, Epidemiology
Unit, Reference Centre on Phylogeny,
Molecular Epidemiology, and Microbial
Evolution (FEMEM), National Institute of
Health, Rome, Italy
Unit of Clinical Laboratory Science,
University of Campus Bio-Medico of Rome,
Internal Medicine Department, University
Campus Bio-Medico of Rome, Rome, Italy
Massimo Ciccozzi, Unit of Clinical Laboratory
Science, University of Campus Bio-Medico of
Rome, Rome, Italy.
Hepatitis B virus (HBV) infection represents the most common cause of chronic liver
diseases worldwide. Consequently, to the introduction of the universal HBV
vaccination program, the prevalence of hepatitis B surface antigen was markedly
reduced and less than 1% of the population of Western Europe and North America is
chronically infected. To date, despite great advances in therapeutics, HBV chronic
infection is considered an incurable disease. Ten hepatitis B virus genotypes (A-J) and
several subgenotypes have been identified so far, based on intergroup divergences of
8% and 4%, respectively, in the complete viral genome. HBV-D genotype has been
found throughout the world, with highest prevalence in the Mediterranean area. In the
present review, several articles concerning HBV epidemiology, and phylogeny in Italy
have been analyzed, mainly focusing on the changes occurred in the last decade.
epidemiology, evolution, hepatitis B virus
chronic hepatitis, liver cirrhosis and hepatocellular carcinoma (HCC).
To date,10 HBV genotypes have been identified, from A to J, based
on a genetic diversity of at least 8% in the viral genome.
genotypes have a distinct geographic distribution worldwide (http://
pdf). HBV-genotype A predominates in Northern Europe and North
America, genotypes B and C in central Asia, genotype D in Mediterra-
nean countries, genotype E in sub-Saharan Africa and in Madagascar,
genotype F in South and Central America, genotypes G and H in Mexico
and some other countries in Central America
and genotypes I and J in
In particular, genotypes B and C prevails in highly endemic
countries where perinatal HBV transmission plays an important role,
whereas genotype A is frequent in areas with primarily horizontal
transmission (ie, sexual contact).
All genotypes are present in
countries of immigration with frequencies depending on the
A brief summary on the usefulness of serum
makers during HBV infection
Presence of hepatitis B surface antigen (HBsAg) in serum indicates an
ongoing HBV infection, acute, or chronic. The serum titre of anti-HBc
IgM (antibody to Hepatitis B core antigen-HBcAg) may help to
diagnose between acute and chronic HBV replication, high titres
indicating a recent active viral replication, and low titres a chronic
lower HBV production.
The titre of serum HBV DNA measures the entity of viral
replication (HBV serum load) which is currently considered useful for
Alessia Lai and Caterina Sagnelli contributed equally to the study.
© 2018 Wiley Periodicals, Inc. wileyonlinelibrary.com/journal/jmv J Med Virol. 2018;90:786–795.