Gina Laure Laghoe’s research while affiliated with Institut Pasteur and other places

Age, marital status, district address in Bangui, and blood borne and sexual risk factors in students and pregnant women in Central Africa Republic (CAR) in year 2010. (DOC)

Students repartition among high schools and University departments. This list corresponds to almost all different high educational entities in Bangui, Central African Republic. (DOC)

Place of living of the studied cohort in the different districts (1–8) of Bangui capital and Bimbo suburbs district in function of HBV and HDV status. The gray scale indicates the economical status of the district. (DOC)

Occupation of subjects from the 2 cohorts (student and pregnant women) in function of HBV and HDV status. (DOC)

Comparison of age, marital status, and blood borne and sexual risk factors in students infected or non-infected by HDV (HDAg ± anti-HD Abs positive versus negative) in CAR in year 2010. (DOCX)

Comparison of age, marital status, and blood borne and sexual risk factors in students infected or non-infected by HBV (HBV positive versus negative) in CAR in year 2010. (DOCX)

A: Consensus tree obtained from the PreC-C region of the HBV genome (nt1814–nt2495) of reference sequence from Galibert et al. (Nature. 1979). HBV DNA was amplified from DNA extracted from the 40 initial ancestral samples with Macherey Nagel extraction procedures. Amplification yielded positive results in 8 samples, and DNA was directly sequenced from both strands. Corresponding sequences were submitted to alignment by Clustal Omega (http/EBI), with 57 references sequences corresponding to pure HBV genotypes and subgenotypes enriched with HBV-E and DE recombinants [19] and submitted to Bayesian analyses. B: Consensus tree obtained from the PreC-C region of the HBV genome (nt1821-nt2066), focused on HBV A, D and E genotypes. HBV DNA was amplified and sequenced from 2010 samples (35 HBV PreC-C sequences). Alignment was manually corrected and submitted to distance models and Bayesian inference. Note that phylogenetic information of the PreC-C region could not well differentiate HBV_D and HBV_E genotypes. (EPS)

Hepatitis delta virus (HDV) increases morbidity in Hepatitis B virus (HBV)-infected patients. In the mid-eighties, an outbreak of HDV fulminant hepatitis (FH) in the Central African Republic (CAR) killed 88% of patients hospitalized in Bangui. We evaluated infections with HBV and HDV among students and pregnant women, 25 years after the fulminant hepatitis (FH) outbreak to determine (i) the prevalence of HBV and HDV infection in this population, (ii) the clinical risk factors for HBV and/or HDV infections, and (iii) to characterize and compare the strains from the FH outbreak in the 1980s to the 2010 HBV–HDV strains. We performed a cross sectional study with historical comparison on FH-stored samples (n = 179) from 159 patients and dried blood-spots from volunteer students and pregnant women groups (n = 2172). We analyzed risk factors potentially associated with HBV and HDV. Previous HBV infection (presence of anti-HBc) occurred in 345/1290 students (26.7%) and 186/870 pregnant women (21.4%)(p = 0.005), including 110 students (8.8%) and 71 pregnant women (8.2%), who were also HBsAg-positive (p = 0.824). HDV infection occurred more frequently in pregnant women (n = 13; 18.8%) than students (n = 6; 5.4%) (p = 0.010). Infection in childhood was probably the main HBV risk factor. The risk factors for HDV infection were age (p = 0.040), transfusion (p = 0.039), and a tendency for tattooing (p = 0.055) and absence of condom use (p = 0.049). HBV-E and HDV-1 were highly prevalent during both the FH outbreak and the 2010 screening project. For historical samples, due to storage conditions and despite several attempts, we could only obtain partial HDV amplification representing 25% of the full-length genome. The HDV-1 mid-eighties FH-strains did not form a specific clade and were affiliated to two different HDV-1 African subgenotypes, one of which also includes the 2010 HDV-1 strains. In the Central African Republic, these findings indicate a high prevalence of previous and current HBV-E and HDV-1 infections both in the mid-eighties fulminant hepatitis outbreak and among asymptomatic young adults in 2010, and reinforce the need for universal HBV vaccination and the prevention of HDV transmission among HBsAg-positive patients through blood or sexual routes.

French to English translated questionnaire. (DOCX)