Influence of hepatitis B virus genotypes on the progression of chronic type B liver disease

Abstract

To investigate the hepatitis B virus (HBV) genotype-related differences in the progression of liver disease, 585 patients with chronic HBV infection including 258 with histologically verified chronic liver disease (CLD) and 74 with hepatocellular carcinoma (HCC) were examined. The mean ages of both patients with advanced fibrosis (F3 or F4) and with HCC were significantly older in genotype B than in genotype C patients (P ‫؍‬ .018, P ‫؍‬ .024, respectively). Both the hepatitis B e antigen (HBeAg) negativity rate at biopsy and the cumulative HBe seroconversion rate in patients with CLD were significantly higher in genotype B patients than genotype C patients (P < .01, P ‫؍‬ .022, respectively). Multivariate analysis revealed that genotype B, presence of precore mutation, high ALT levels, and severe histologic activity were independent factors for HBe seroconversion. Among all the biopsyproven CLD patients, the ratio of patients with advanced fibrosis in genotype B was significantly lower than that in genotype C (4/30 vs. 74/224, respectively; P ‫؍‬ .034). This difference was more remarkable in younger patients (<45 years; 1/25 vs. 47/180, respectively; P ‫؍‬ .020), and there was no difference in older patients (>45 years). The distribution of each genotype between CLD and HCC was very similar (B and C: 11.2% and 87.0% vs. 10.8% and 89.2%, respectively). In conclusion, our results suggest that, although the patients with genotype B experience earlier HBe seroconversion, slower progression of liver fibrosis, and slower development of HCC, the life-long risk of progression to advanced fibrosis and development of HCC may not differ among genotypes B-and C-related chronic liver disease. (HEPATOLOGY 2003;37:19-26.)

Determinants for sustained HBeAg response to lamivudine therapy

“…Consistent with an earlier study, 27 our patients with genotype C HBV infection also had higher hepatitis activity, including HAI scores, periportal inflammation, fibrosis scores, and scores excluding fibrosis. Although total HAI score in relapsers was significantly higher than that of sustained responders, none of these histologic scores was an independent factor of sustained response (Table 3).…”

Distribution of Hepatitis B Virus Genotypes and Its Association with Severity of Liver Disease in Patients with Chronic Hepatitis B in Uttar Pradesh, India

“…Our results are in accordance with the latter studies which showed the dominancy of genotype D on A. HBV genotypes have been shown to have a distinct geographic distribution. Genotypes B and C are prevalent in the East and South-East Asia [26]. In contrast, genotypes A and D are common in Western Europe and North America [19,24].…”

Virological outcomes in patients infected chronically with hepatitis B virus genotype A in comparison with genotypes B and C

“…Differences between genotypes B and C in Asia [Kao et al, 2000;Orito et al, 2001;Tsubota et al, 2001;Chan et al, 2004;Yu et al, 2005] have not been reproduced, probably due to selection bias for the patients with severe disease [Sumi et al, 2003] or subgenotypes of B different between Japan (Bj) and Hong Kong (Ba) [Yuen et al, 2004]. Liver disease, once advanced beyond a certain severity, will progress spontaneously irrespective of HBV genotypes.…”