Hepatitis B-associated vasculitis in Alaska Natives: viral genotype, clinical and serologic outcome.
BACKGROUND
The highest incidence of hepatitis B virus (HBV)-associated vasculitis in the world has been reported in Alaska Natives. We examined the incidence of HBV-associated vasculitis before and after mass HBV vaccine immunization and the association between HBV genotype and vasculitis in a population-based cohort study in Alaska natives chronically infected with HBV.


METHODS
Genotyping was performed in vasculitis cases and 644 hepatitis B-positive controls without vasculitis using polymerase chain reaction and sequencing of the S gene. Occurrence of HBV vasculitis from 1974 to 2004 was calculated. HBV vasculitis patients and controls were also tested for basal core promoter and precore mutations.


RESULTS
Fifteen cases of HBV-associated vasculitis were identified: 13 (86%) had genotype D and one each genotype A and F. Genotype D was more commonly found in patients with vasculitis than controls [odd ratio (OR)=5.9, confidence interval (95% CI) 1.2, 21.8; P<0.015).


CONCLUSIONS
HBV-associated vasculitis was associated with genotype D.
Hurlburt
Kathy J
KJ
Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AK 99508, USA. kjhurlburt@anmc.org
McMahon
Brian J
BJ
Simonetti
Josephine P
JP
Livingston
Stephen E
SE
Bulkow
Lisa R
LR
Snowball
Mary M
MM
Chulanov
Vladimir P
VP
Nainan
Omana P
OP
Williams
James L
JL
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D005814:Genes, Viral; D005838:Genotype; D006509:Hepatitis B / Q000150:complications* / Q000208:ethnology / Q000821:virology; D006515:Hepatitis B virus / Q000235:genetics*; D006801:Humans; D004930:Inuit; D008297:Male; D008875:Middle Aged; D009154:Mutation; D016896:Treatment Outcome; D014657:Vasculitis / Q000208:ethnology / Q000209:etiology*
D004279:DNA, Viral