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Significance of hepatitis B genotype in acute exacerbation, HBeAg seroconversion, cirrhosis‐related complications, and hepatocellular carcinoma
Author(s) -
Yuen ManFung,
Sablon Erwin,
Yuan HeJun,
Wong Danny KaHo,
Hui CheeKin,
Wong Benjamin ChunYu,
Chan Annie OnOn,
Lai Ching Lung
Publication year - 2003
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1053/jhep.2003.50098
Subject(s) - genotype , hepatocellular carcinoma , hbeag , seroconversion , cirrhosis , medicine , exacerbation , hepatitis b virus , gastroenterology , hepatitis b , orthohepadnavirus , virology , hepadnaviridae , immunology , hbsag , biology , virus , gene , genetics
The pathologic role of hepatitis B virus (HBV) genotype in Chinese patients with HBV infection is largely unknown. We examined the relationship between HBV genotypes, and hepatitis B e antigen (HBeAg) seroconversion, acute exacerbation, cirrhosis‐related complications, and precore/core promoter mutations. Three hundred forty‐three HBV patients (288 were asymptomatic, 55 presented with cirrhosis‐related complications) were recruited. HBV genotypes and precore/core promoter mutations were determined by line probe assays. Genotypes B and C were the 2 most common genotypes, contributing 28% and 60%, respectively. The median age of HBeAg seroconversion for patients with genotype B was 9 years earlier than patients with genotype C ( P = .011). There were no differences in the liver biochemistry, HBV DNA level, and cumulative risk of acute exacerbation (defined as increased alanine aminotransferase level ≥1.5 × upper limit of normal) between patients with genotypes B and C. There was a trend for patients with genotype B to have a higher cumulative rate of HBeAg seroconversion compared with patients with genotype C at the initial follow‐up of 6 years ( P = .053), but this difference became insignificant during subsequent follow‐up. The prevalence of both genotypes was the same in patients with and without cirrhosis‐related complications and/or hepatocellular carcinoma. Genotype B was associated with precore mutations ( P < .0001), whereas genotype C was associated with core promoter mutations ( P < .0001). In conclusion, although patients with genotype B had earlier HBeAg seroconversion, there was no significant reduction in the risk of development of complications. Genotypes B and C are associated with high prevalence of precore and core promoter mutations, respectively.