Gastroenterology

Gastroenterology

Volume 118, Issue 3, March 2000, Pages 554-559
Gastroenterology

Liver, Pancreas, and Biliary Tract
Hepatitis B genotypes correlate with clinical outcomes in patients with chronic hepatitis B,☆☆

https://doi.org/10.1016/S0016-5085(00)70261-7Get rights and content

Abstract

Background & Aims: Six genotypes (A–F) of hepatitis B virus (HBV) have been identified; however, the genotype-related differences in the pathogenicity of HBV remain unknown. Therefore, we investigated the prevalence of HBV genotypes in Taiwan and the association between distinct genotypes and severity of liver disease in a cross-sectional study. Methods: Using a molecular method, HBV genotypes were determined in 100 asymptomatic carriers and in 170 patients with histologically verified chronic liver disease and hepatocellular carcinoma (HCC). Results: All genotypes except genotype E were identified in Taiwan, and genotypes B and C were predominant. Genotype C was prevalent in patients with cirrhosis and in those with HCC who were older than 50 years compared with age-matched asymptomatic carriers (60% vs. 23%, P < 0.001, and 41% vs. 15%, P = 0.005, respectively). Genotype B was significantly more common in patients with HCC aged less than 50 years compared with age-matched asymptomatic carriers (80% vs. 52%, P = 0.03). This predominance was more marked in younger patients with HCC (90% in those aged ≤35 years), most of whom did not have cirrhosis. Conclusions: Our data suggest that HBV genotype C is associated with more severe liver disease and genotype B may be associated with the development of HCC in young Taiwanese. However, additional large-scale longitudinal studies are needed to confirm the relationship of HBV genotypes to liver disease severity and clinical outcomes.

GASTROENTEROLOGY 2000;118:554-559

Section snippets

Patients and HBsAg carriers

Serum samples were obtained from 270 chronic HBV carriers with long-term follow-up at the gastroenterological clinics of the National Taiwan University Hospital. They included 100 asymptomatic HBsAg carriers who had persistently normal serum alanine aminotransferase (ALT) levels for at least 3 years in periodic biochemical examinations (every 3 or 6 months) and were considered asymptomatic HBsAg carriers and 170 HBsAg-positive patients with histologically verified chronic liver disease and HCC

Results

The demographic and clinical data in the 100 asymptomatic HBsAg carriers and 170 HBsAg-positive patients with various liver diseases are shown in Table 1. No significant difference in male-to-female ratios was observed in the 6 groups, mean age was significantly higher in HCC patients (P < 0.001), and serum ALT level and positive HBeAg rate were significantly higher in patients with moderate-to-severe chronic hepatitis than in other groups (P < 0.001).

The genotype distribution in the 270 HBV

Discussion

The entire nucleotide sequences of human HBV genomes of various subtypes have been classified into 6 genotypes, designated A–F.9, 10 Several studies have proposed the geographic distribution of each genotype.13, 14, 19, 20 Genotype A is the predominant genotype in northern Europe; genotypes B and C are confined to populations with origins in eastern Asia and the Far East; genotype D is found worldwide, but prevails in the Mediterranean area, the Near and Middle East, and south Asia; genotype E

Acknowledgements

The authors thank Dr. Mu-Zon Wu at the Department of Pathology of National Taiwan University Hospital for grading the degree of hepatic inflammation and fibrosis.

References (31)

  • JL Sung et al.

    Geographical distribution of the subtype of hepatitis B surface antigen in Chinese

    Gastroenterol Jpn

    (1977)
  • H Okamoto et al.

    Typing hepatitis B virus by homology in nucleotide sequence: comparison of surface antigen subtypes

    J Gen Virol

    (1988)
  • H Norder et al.

    Molecular basis of hepatitis B virus serotype variations within the four major subtypes

    J Gen Virol

    (1992)
  • H Norder et al.

    Comparison of the amino acid sequences of nine different serotypes of hepatitis B surface antigen and genomic classification of the corresponding hepatitis B virus strains

    J Gen Virol

    (1992)
  • H Norder et al.

    Genetic relatedness of hepatitis B viral strains of diverse geographical origin and natural variations in the primary structure of the surface antigen

    J Gen Virol

    (1993)
  • Cited by (880)

    • Molecular testing in hepatitis virus-related disease

      2023, Diagnostic Molecular Pathology: A Guide to Applied Molecular Testing, Second Edition
    • Liver Cancer (Current Therapies)

      2022, Comprehensive Pharmacology
    View all citing articles on Scopus

    Supported by grants from the Department of Health and the National Science Council, Executive Yuan, Taiwan.

    ☆☆

    Address requests for reprints to: Ding-Shinn Chen, M.D., Hepatitis Research Center, National Taiwan University Hospital, 1 Chang-Te Street, Taipei, Taiwan 100. e-mail: [email protected]; fax: (886) 2-23317624.

    View full text