Evolutionary dynamics of HBV-D7 subgenotype in Tunisia

Massimo Ciccozzi, Houda Chaouch, Alessandra Lo Presti, Stefania Taffon, Umbertina Villano, Michele Equestre, Roberto Bruni, Cinzia Marcantonio, Elena Tritarelli, Eleonora Cella, Aletheia Blasi, Mahjoub Aouni, Amel Letaief, Anna Rita Ciccaglione

Research output: Contribution to journalArticlepeer-review


Hepatitis B virus (HBV) is the main cause of diseases liver related infecting more than 200 milion persons worldwide. HBV infection shows high level of prevalence in South-East Europe and in Mediterranean basin. In Tunisia, a country with an intermediate level endemicity, HbsAg prevalence ranges from 2 to 5%. Most of the HBV isolates from Tunisia were classified as subgenotype D7 whose circulation is restricted to a specific area of North Africa including Maghreb region. In this paper, the phylogeny of HBV-D7 isolated from 38 Tunisian patients was investigated by analyzing the S gene region of HBV. A Bayesian coalescent-based framework was used to estimate the origin of the HBV-D7 in the country. The Tunisian D7 isolates were found to share a common ancestor whose origin was traced back to 1958. Population dynamics indicated that HBV-D7 epidemic in Tunisia grew exponentially from 1960s to 1990s. After that, the curve reached a plateau around the years 2000 likely due to the implementation of the infant vaccination program in 1996. Epidemiological data suggested that the exponential growth phase was likely sustained by intra-familial transmission events occurring during infancy. Further characterization of HBV-D7 isolates should be performed to evaluate, in the post-vaccination era, the emergence of new transmission routes, and to monitor the efficacy of the vaccination program. J. Med. Virol. 89:469–475, 2017.

Original languageEnglish
Pages (from-to)469-475
Number of pages7
JournalJournal of Medical Virology
Issue number3
Publication statusPublished - Mar 1 2017


  • epidemiology
  • evolution
  • hepatitis B virus

ASJC Scopus subject areas

  • Infectious Diseases
  • Virology


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