title: Hepatic necroinflammation and fibrosis in patients with genotypes Ba and C, core-promoter and precore mutations.
abstract: The role of infection with hepatitis B virus (HBV) genotypes on liver histology is largely unknown. The aim of study was to investigate the relationships between HBV genotypes (B, C), core-promoter (CP) and precore mutants and liver histology in 66 patients. Liver biopsies were scored by histologic activity index (HAI). HBV genotypes were determined by enzyme-linked immunosorbent assay (ELISA). Eighteen (27.3%) and 48 patients (72.7%) had genotype B (all were subtype Ba) and C, respectively. Forty-seven (71.2%) and 27 (40.9%) had CP and precore mutations, respectively. Patients with genotype C compared with subtype Ba had higher median scores of HAI-necroinflammation (HAI-NI) (7 vs 3), HAI-fibrosis (HAI-F) (1 vs 0) and total HAI (8.5 vs 3) (all P < 0.03). Patients with CP mutations compared with wild-type had higher median scores of HAI-NI (7 vs 3), HAI-F (3 vs 0) and total HAI (9 vs 3) (all P < 0.03). Forty patients (83.5%) with genotype C had CP mutations. Age and alanine aminotransferase levels were positively correlated with HAI scores while albumin levels were negatively correlated (P < 0.01 for all, except albumin levels and HAI-F, P = 0.08). There was no association between precore mutations and HAI scores. Multivariate analysis indicated that higher alanine aminotransferase (ALT) levels were associated with higher HAI scores (P < 0.04) and CP mutations were associated with higher HAI-NI (P = 0.034), but not with HAI-F score (P = 0.3). CP mutations were associated with more severe necroinflammation. The association between genotype C and poor histology was probably because of the association between genotype C and CP mutations.
authors.affiliation: Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China. yuenmf@netvigator.com
authors.forename: M-F
authors.initials: MF
authors.lastname: Yuen
authors.forename: Y
authors.initials: Y
authors.lastname: Tanaka
authors.forename: I O-L
authors.initials: IO
authors.lastname: Ng
authors.forename: M
authors.initials: M
authors.lastname: Mizokami
authors.forename: J C-H
authors.initials: JC
authors.lastname: Yuen
authors.forename: D K-H
authors.initials: DK
authors.lastname: Wong
authors.forename: H-J
authors.initials: HJ
authors.lastname: Yuan
authors.forename: S-M
authors.initials: SM
authors.lastname: Sum
authors.forename: A O-O
authors.initials: AO
authors.lastname: Chan
authors.forename: C-L
authors.initials: CL
authors.lastname: Lai
mesh_terms: D005838:Genotype; D006512:Hepatitis B Core Antigens / Q000235:genetics*; D006515:Hepatitis B virus / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology* / Q000503:physiopathology; D009154:Mutation; D011401:Promoter Regions, Genetic
chemical_list: D006512:Hepatitis B Core Antigens