High prevalence of HBV genotype D in Syria and the clinical characteristics of hepatitis B e antigen-negative chronic hepatitis B.

Hepatitis B virus (HBV) genotype D and hepatitis B e antigen (HBeAg) negative chronic hepatitis are the most prevalent in Mediterranean countries. No data have ever been published on their prevalence in Syria, a country of intermediate endemicity for HBV. The aims of the current study were to determine the HBV genotype distribution in Syria, the prevalence of HBeAg-positive and HBeAg-negative chronic hepatitis and to analyse the clinical characteristics of each group. A total of 220 patients were included. Ninety-seven percent of the patients were of genotype D, and 72% were HBeAg negative. The HBeAg-negative patients were older, had a lower viral load, had more cirrhosis and the mode of contamination was known less than for HBeAg-positive patients. These findings have major implications in understanding the natural history of the infection and are of great relevance in the choice of therapy.

The unexpected discovery of a focus of hepatitis C virus genotype 5 in a Syrian province.

Genotype 5 (G5) was initially discovered and is still mainly diagnosed in South Africa. No cases of G5 have ever been reported from the Middle East countries. The aim of the study was to determine the hepatitis C virus (HCV) genotype distribution in Syria and the prevalence of G5 in this country. Genotyping of HCV was performed in 636 consecutive HCV patients referred to eight medical centres in Syria over a 3-year period. Genotype 4 was the most frequent genotype (375 patients, 59%) followed by genotype 1 (181 patients, 28.5%) and G5 (64 patients, 10%). The majority of G5 patients (56 cases, 87%) live in the north of Syria, including 21 cases (33%) from Azaz, a small city close to Turkey. No obvious epidemiological reason for such high prevalence of G5 was found.