title: Distinct geographic distributions of hepatitis B virus genotypes in patients with acute infection in Japan.
abstract: Genotypes of hepatitis B virus (HBV) were determined in 145 patients with acute hepatitis B from various districts in Japan to establish their geographic distribution and evaluating the influence on the clinical illness and outcome. Genotypes were A in 27 (19%) patients, B in 8 (5%), C in 109 (75%) and mixed with B and C in the remaining one (1%). Genotype A was more frequent in metropolitan than the other areas (21/69 (30%) vs. 6/76 (8%), P < 0.001). On phylogenetic analysis, seven of the nine (78%) HBV/A isolates selected at random clustered with those from Europe and the United States, while the remaining two with those of subgroup A' prevalent in Asia and Africa. Maximum ALT levels were lower (2069 +/- 1075 vs. 2889 +/- 1867 IU/L, P = 0.03) and baseline HBV DNA titers were higher (5.90 +/- 1.45 vs. 5.13 +/- 1.36 log genome equivalents (LGE)/ml, P = 0.002) in patients infected with genotype A than C. Hepatitis B surface antigen persisted longer in patients infected with genotype A than C (1.95 +/- 1.09 vs. 1.28 +/- 1.42 months, P = 0.02). HBV infection became chronic in one (4%) patient with genotype A and one (1%) with genotype C infection. Fulminant hepatic failure developed in none of the patients with genotype A, one (13%) with genotype B and five (5%) with genotype C. The point mutation in the precore region (A1896) or the double mutations in the basic core promoter (BCP) region (T1762/A1764) were detected in none of the patients with genotype A, two (25%) with genotype B and 27 (26%) with genotype C. In conclusion, genotype A is frequent in patients with acute hepatitis B in metropolitan areas of Japan, probably reflecting particular transmission routes, and associated with longer and milder clinical course than genotype C.
authors: Department of Internal Medicine, Division of Gastroenterology and Hepatology, St. Marianna University School of Medicine, Kawasaki, Japan. hyotsu@marianna-u.ac.jp
authors: Hiroshi
authors: H
authors: Yotsuyanagi
authors: Chiaki
authors: C
authors: Okuse
authors: Kiyomi
authors: K
authors: Yasuda
authors: Etsuro
authors: E
authors: Orito
authors: Shuhei
authors: S
authors: Nishiguchi
authors: Joji
authors: J
authors: Toyoda
authors: Eiichi
authors: E
authors: Tomita
authors: Keisuke
authors: K
authors: Hino
authors: Kiwamu
authors: K
authors: Okita
authors: Shiro
authors: S
authors: Murashima
authors: Michio
authors: M
authors: Sata
authors: Hiromi
authors: H
authors: Hoshino
authors: Yuzo
authors: Y
authors: Miyakawa
authors: Shiro
authors: S
authors: Iino
mesh_terms: D000328:Adult; D005260:Female; D005838:Genotype; D006512:Hepatitis B Core Antigens / Q000235:genetics*; D006515:Hepatitis B virus / Q000145:classification / Q000235:genetics* / Q000378:metabolism; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D010802:Phylogeny
chemical_list: D006512:Hepatitis B Core Antigens