Genotype C hepatitis B virus infection is associated with a higher risk of reactivation of hepatitis B and progression to cirrhosis than genotype B: a longitudinal study of hepatitis B e antigen-positive patients with normal aminotransferase levels at baseline.
OBJECTIVE
Longitudinal studies on the relationship between hepatitis B virus (HBV) genotypes and reactivation of hepatitis B and progression to cirrhosis were very rare.


METHODS
Liver biochemistry, virological markers and ultrasound were monitored in 202 hepatitis B e antigen (HBeAg)-positive patients with normal alanine aminotransferase (ALT) at baseline for 3-20 (average 10.8) years, and the outcome was correlated with HBV genotypes.


RESULTS
There were 150 genotype B and 52 genotype C patients. Hepatitis activity during the HBeAg-positive phase showed no significant difference. However, genotype B was associated with a significantly earlier and higher rate of HBeAg seroconversion. HBeAg seroconversion correlated with age at entry for genotype B and with ALT levels for genotype C. Reactivation of hepatitis B was significantly more common in genotype C patients. Five genotype B and 10 genotype C patients progressed to cirrhosis. Multivariate analysis revealed that genotype C (P = 0.03) and reactivation of hepatitis B (P = 0.0004) were independent factor predictive of cirrhosis.


CONCLUSIONS
Rate and factors of HBeAg seroconversion, and rate of reactivation of hepatitis B differed between genotype B and genotype C patients. Genotype C and reactivation of hepatitis B were associated with increased risk of cirrhosis.
Chu
Chia-Ming
CM
Liver Research Unit, Chang Gung Memorial Hospital and Chang Gung University Taipei, 199, Tung Hwa North Road, Taipei 105, Taiwan, ROC. chu0066@cgmh.org.tw
Liaw
Yun-Fan
YF
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D018450:Disease Progression; D005260:Female; D005838:Genotype; D006509:Hepatitis B / Q000453:epidemiology / Q000503:physiopathology*; D006511:Hepatitis B Antigens / Q000032:analysis; D006513:Hepatitis B e Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000145:classification / Q000235:genetics*; D006801:Humans; D008103:Liver Cirrhosis / Q000821:virology*; D008137:Longitudinal Studies; D008297:Male; D011336:Probability; D012189:Retrospective Studies; D012306:Risk
D006511:Hepatitis B Antigens; D006513:Hepatitis B e Antigens; D000410:Alanine Transaminase