Influence of hepatitis B virus genotypes on the progression of chronic type B liver disease.
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 biopsy-proven 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 (< or =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.
Sumi
Hajime
H
Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Japan.
Yokosuka
Osamu
O
Seki
Naohiko
N
Arai
Makoto
M
Imazeki
Fumio
F
Kurihara
Tomoko
T
Kanda
Tatsuo
T
Fukai
Kenichi
K
Kato
Masaki
M
Saisho
Hiromitsu
H
D000328:Adult; D017677:Age Distribution; D001706:Biopsy; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006513:Hepatitis B e Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence
D006513:Hepatitis B e Antigens