Influence of hepatitis B virus genotype on the long-term outcome of chronic hepatitis B in western patients.
OBJECTIVE
The aim of this study was to investigate if the variable outcome of chronic hepatitis B may be related to hepatitis B virus (HBV) genotype.


METHODS
The clinical and virologic events observed over prolonged follow-up in 258 Spanish patients with chronic hepatitis B infected with different genotypes of HBV were compared.


RESULTS
The prevalence of genotype A, D, and F was 52%, 35%, and 7%, respectively. Concomitant sustained biochemical remission and clearance of HBV DNA occurred at a higher rate in genotype A- than in genotype D- (log-rank, 14.2; P = 0.002) or genotype F-infected patients (log-rank, 4.2; P = 0.03). The rate of hepatitis B surface antigen (HBsAg) clearance was higher in genotype A than in genotype D hepatitis (log-rank, 4.6; P = 0.03). Sustained remission and clearance of HBsAg were associated with infection with genotype A by Cox regression analysis. Seroconversion to antibody to hepatitis B e antigen (anti-HBe) was unrelated to HBV genotype, but the rate of sustained remission after seroconversion was higher in genotype A than in genotype D hepatitis both in patients who seroconverted to anti-HBe during follow-up (log-rank, 4.5; P = 0.03) and in patients with positive anti-HBe at baseline (log-rank, 6.66; P = 0.009). Death related to liver disease was more frequent in genotype F than in genotype A (P = 0.02) or genotype D (P = 0.002) hepatitis.


CONCLUSIONS
The long-term outcome of chronic hepatitis B is different in patients infected with HBV genotype A, D, or F.
Sánchez-Tapias
José M
JM
Liver Unit, Institut de Malalties Digestives, Hospital Clínic, University of Barcelona, IDIBAPS, Spain. sanchez@medicina.ub.es
Costa
Josep
J
Mas
Antoni
A
Bruguera
Miquel
M
Rodés
Juan
J
D000328:Adult; D004279:DNA, Viral / Q000097:blood; D005260:Female; D005787:Gene Frequency; D005838:Genotype; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000188:drug therapy / Q000235:genetics / Q000503:physiopathology / Q000821:virology*; D006801:Humans; D008099:Liver / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome
D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens