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The Brazilian Amazon Region is a highly endemic area for hepatitis B virus (HBV). However, little is known regarding the genetic variability of the strains circulating in this geographical region. Here, we describe the first full-length genomes of HBV isolated in the Brazilian Amazon Region; these genomes are also the first complete HBV subgenotype D3 genomes reported for Brazil. The genomes of the five Brazilian isolates were all 3,182 base pairs in length and the isolates were classified as belonging to subgenotype D3, subtypes ayw2 (n = 3) and ayw3 (n = 2). Phylogenetic analysis suggested that the Brazilian sequences are not likely to be closely related to European D3 sequences. Such results will contribute to further epidemiological and evolutionary studies of HBV.

In this chapter we discuss the global epidemiology of hepatitis B virus (HBV) in the general population and compare the data with those from populations at higher risk for hepatitis B infection, as hemodialysis patients. We discuss disease burden, HBV genotype distribution, and patterns of HBV transmission in the general population and among hemodialysis patients. We focus on the importance of detecting occult HBV infection in hemodialysis. Finally, we compare HBV variants detected in the general population with those detected by nosocomial transmission in hemodialysis units.