Ongoing transmission of hepatitis B virus in rural parts of the Netherlands, 2009-2013.

<h4>Background</h4>Reported acute hepatitis B incidence in the Netherlands reached its nadir in 2013. However, regional signals about increased number of hepatitis B cases raised the question how hepatitis B incidence was distributed over the country. In this study, regional differences...

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Main Authors: Loes C Soetens, Birgit H B van Benthem, Anouk Urbanus, Jeroen Cremer, Kimberly S M Benschop, Ariene Rietveld, Erik I van Dijk, Susan J M Hahné
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2015-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0117703&type=printable
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author Loes C Soetens
Birgit H B van Benthem
Anouk Urbanus
Jeroen Cremer
Kimberly S M Benschop
Ariene Rietveld
Erik I van Dijk
Susan J M Hahné
author_facet Loes C Soetens
Birgit H B van Benthem
Anouk Urbanus
Jeroen Cremer
Kimberly S M Benschop
Ariene Rietveld
Erik I van Dijk
Susan J M Hahné
author_sort Loes C Soetens
collection DOAJ
description <h4>Background</h4>Reported acute hepatitis B incidence in the Netherlands reached its nadir in 2013. However, regional signals about increased number of hepatitis B cases raised the question how hepatitis B incidence was distributed over the country. In this study, regional differences in hepatitis B epidemiology were investigated using epidemiological and molecular data.<h4>Methods</h4>Acute hepatitis B virus (HBV) infections, reported between 2009-2013, were included. If serum was available, a fragment of S and C gene of the HBV was amplified and sequenced. Regional differences in incidence were studied by geographical mapping of cases and cluster analysis. Regional differences in transmission were studied by constructing regional maximum parsimony trees based on the C gene to assess genetic clustering of cases.<h4>Results</h4>Between 2009 and 2013, 881 cases were notified, of which respectively 431 and 400 cases had serum available for S and C gene sequencing. Geographical mapping of notified cases revealed that incidences in rural border areas of the Netherlands were highest. Cluster analysis identified two significant clusters (p<0.000) in the South-western and North-eastern regions. Genetic cluster analysis showed that rural border areas had relatively large clusters of cases with indistinguishable sequences, while other regions showed more single introductions.<h4>Conclusion</h4>This study showed that regional differences in HBV epidemiology were present in the Netherlands. Rural border regions showed higher incidences and more ongoing transmission, mainly among MSM, than the more urban inland areas. Therefore, preventive measures should be enhanced in these regions.
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spelling doaj-art-87eb929401944ced9158cfb14f080efa2025-08-20T02:15:02ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01102e011770310.1371/journal.pone.0117703Ongoing transmission of hepatitis B virus in rural parts of the Netherlands, 2009-2013.Loes C SoetensBirgit H B van BenthemAnouk UrbanusJeroen CremerKimberly S M BenschopAriene RietveldErik I van DijkSusan J M Hahné<h4>Background</h4>Reported acute hepatitis B incidence in the Netherlands reached its nadir in 2013. However, regional signals about increased number of hepatitis B cases raised the question how hepatitis B incidence was distributed over the country. In this study, regional differences in hepatitis B epidemiology were investigated using epidemiological and molecular data.<h4>Methods</h4>Acute hepatitis B virus (HBV) infections, reported between 2009-2013, were included. If serum was available, a fragment of S and C gene of the HBV was amplified and sequenced. Regional differences in incidence were studied by geographical mapping of cases and cluster analysis. Regional differences in transmission were studied by constructing regional maximum parsimony trees based on the C gene to assess genetic clustering of cases.<h4>Results</h4>Between 2009 and 2013, 881 cases were notified, of which respectively 431 and 400 cases had serum available for S and C gene sequencing. Geographical mapping of notified cases revealed that incidences in rural border areas of the Netherlands were highest. Cluster analysis identified two significant clusters (p<0.000) in the South-western and North-eastern regions. Genetic cluster analysis showed that rural border areas had relatively large clusters of cases with indistinguishable sequences, while other regions showed more single introductions.<h4>Conclusion</h4>This study showed that regional differences in HBV epidemiology were present in the Netherlands. Rural border regions showed higher incidences and more ongoing transmission, mainly among MSM, than the more urban inland areas. Therefore, preventive measures should be enhanced in these regions.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0117703&type=printable
spellingShingle Loes C Soetens
Birgit H B van Benthem
Anouk Urbanus
Jeroen Cremer
Kimberly S M Benschop
Ariene Rietveld
Erik I van Dijk
Susan J M Hahné
Ongoing transmission of hepatitis B virus in rural parts of the Netherlands, 2009-2013.
PLoS ONE
title Ongoing transmission of hepatitis B virus in rural parts of the Netherlands, 2009-2013.
title_full Ongoing transmission of hepatitis B virus in rural parts of the Netherlands, 2009-2013.
title_fullStr Ongoing transmission of hepatitis B virus in rural parts of the Netherlands, 2009-2013.
title_full_unstemmed Ongoing transmission of hepatitis B virus in rural parts of the Netherlands, 2009-2013.
title_short Ongoing transmission of hepatitis B virus in rural parts of the Netherlands, 2009-2013.
title_sort ongoing transmission of hepatitis b virus in rural parts of the netherlands 2009 2013
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0117703&type=printable
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AT anoukurbanus ongoingtransmissionofhepatitisbvirusinruralpartsofthenetherlands20092013
AT jeroencremer ongoingtransmissionofhepatitisbvirusinruralpartsofthenetherlands20092013
AT kimberlysmbenschop ongoingtransmissionofhepatitisbvirusinruralpartsofthenetherlands20092013
AT arienerietveld ongoingtransmissionofhepatitisbvirusinruralpartsofthenetherlands20092013
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