Clinical relevance of hepatitis B virus genotype in children with chronic infection and hepatocellular carcinoma.
OBJECTIVE
The aim of this study was to investigate the influence of hepatitis B virus (HBV) genotypes on the clinical outcome of chronic childhood HBV infection and hepatocellular carcinoma (HCC).


METHODS
A total of 460 HBV carrier children were followed-up for 15 years and 26 children with HBV-related HCC were recruited. HBV genotyping was examined at enrollment and the latest follow-up of these carrier children and at diagnosis in HCC children. Viral load was checked at enrollment for the carrier children. These carriers were grouped based on their initial hepatitis B e antigen (HBeAg) and antibody to hepatitis B e antigen (anti-HBe) status. The HBeAg positive (+) group was divided further into an HBeAg(+/+) group and HBeAg(+/-) group, depending on whether spontaneous HBeAg seroconversion occurred during the follow-up period.


RESULTS
Genotype B constituted 73%, 86%, and 76% in the HBeAg(+/+), HBeAg(+/-), and anti-HBe(+) groups, respectively. Genotype C was found in 27%, 8%, and 6% in the HBeAg(+/+), HBeAg(+/-), and anti-HBe(+) group, respectively. Genotype C carriers were more prevalent in the HBeAg(+/+) group than the other 2 groups (P = .01), and had a delayed HBeAg seroconversion compared with the genotype B carriers (P < .001). Changes of genotype during the follow-up period were rare (2.8%). In those with HCC, genotype B was also the major type (74%). There was no difference in the baseline viral load between genotypes B and C.


CONCLUSIONS
Although HBV genotype B dominates in children with chronic HBV infection and HCC in Taiwan, genotype C delays HBeAg seroconversion in pediatric chronic HBV infection.
Ni
Yen-Hsuan
YH
Department of Pediatrics, College of Medicine, National Taiwan University, Taipei 100. Taiwan.
Chang
Mei-Hwei
MH
Wang
Kuan-Jan
KJ
Hsu
Hong-Yuan
HY
Chen
Huey-Ling
HL
Kao
Jia-Horng
JH
Yeh
Shiou-Hwei
SH
Jeng
Yung-Ming
YM
Tsai
Keh-Sung
KS
Chen
Ding-Shinn
DS
D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000821:virology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006515:Hepatitis B virus / Q000235:genetics* / Q000472:pathogenicity; D019694:Hepatitis B, Chronic / Q000473:pathology / Q000821:virology*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000821:virology*; D008297:Male; D011379:Prognosis; D019562:Viral Load