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Impact of the hepatitis B virus genotype and genotype mixtures on the course of liver disease in Vietnam
Author(s) -
Toan Nguyen L.,
Song Le H.,
Kremsner Peter G.,
Duy Dinh N.,
Binh Vu Q.,
Koeberlein Bernd,
Kaiser Stefan,
Kandolf Reinhard,
Torresi Joseph,
Bock C.Thomas
Publication year - 2006
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.21188
Subject(s) - genotype , virology , disease , hepatitis b virus , course (navigation) , liver disease , medicine , virus , hepatitis c virus , biology , genetics , gene , physics , astronomy
Abstract Eight genotypes (A‐H) of hepatitis B virus (HBV) have been identified. However, the impact of different genotypes on the clinical course of hepatitis B infection remains controversial. We investigated the frequency and clinical outcome of HBV genotypes and genotype mixtures in HBV‐infected patients from Vietnam, Europe, and Africa. In addition, we analyzed the effects of genotype mixtures on alterations in in vitro viral replication. In Asian patients, seven genotypes (A‐G) were detected, with A, C, and D predominating. In European and African patients, only genotypes A, C, D, and G were identified. Genotype mixtures were more frequently encountered in African than in Asian ( P = .01) and European patients ( P = .06). In Asian patients, the predominant genotype mixtures included A/C and C/D, compared to C/D in European and A/D in African patients. Genotype A was more frequent in asymptomatic compared with symptomatic patients ( P < .0001). Genotype C was more frequent in patients with hepatocellular carcinoma (HCC; P = .02). Genotype mixtures were more frequently encountered in patients with chronic hepatitis in comparison to patients with acute hepatitis B ( P = .015), liver cirrhosis ( P = .013), and HCC ( P = .002). Viral loads in patients infected with genotype mixtures were significantly higher in comparison to patients with a single genotype ( P = .019). Genotype mixtures were also associated with increased in vitro HBV replication. In conclusion , infection with mixtures of HBV genotypes is frequent in Asia, Africa, and Europe. Differences in the replication‐phenotype of single genotypes compared to genotype‐mixtures suggest that co‐infection with different HBV‐genotypes is associated with altered pathogenesis and clinical outcome. (H EPATOLOGY 2006;43:1375–1384.)