title: Clinical relevance of hepatitis B virus genotype in children with chronic infection and hepatocellular carcinoma.
abstract: 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.
authors.affiliation: Department of Pediatrics, College of Medicine, National Taiwan University, Taipei 100. Taiwan.
authors.forename: Yen-Hsuan
authors.initials: YH
authors.lastname: Ni
authors.forename: Mei-Hwei
authors.initials: MH
authors.lastname: Chang
authors.forename: Kuan-Jan
authors.initials: KJ
authors.lastname: Wang
authors.forename: Hong-Yuan
authors.initials: HY
authors.lastname: Hsu
authors.forename: Huey-Ling
authors.initials: HL
authors.lastname: Chen
authors.forename: Jia-Horng
authors.initials: JH
authors.lastname: Kao
authors.forename: Shiou-Hwei
authors.initials: SH
authors.lastname: Yeh
authors.forename: Yung-Ming
authors.initials: YM
authors.lastname: Jeng
authors.forename: Keh-Sung
authors.initials: KS
authors.lastname: Tsai
authors.forename: Ding-Shinn
authors.initials: DS
authors.lastname: Chen
mesh_terms: 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