Genetic characteristics of hepatitis B virus genotypes as a factor for interferon-induced HBeAg clearance.
The factors determining the responsiveness of different hepatitis B virus (HBV) genotypes to interferon treatment are not fully understood. We investigated the relationship between HBV genetic characteristics and the outcome of short (16 weeks) or prolonged (32 weeks) treatment with standard interferon-alpha in a prospectively followed cohort of 103 patients across Europe with HBeAg positive chronic hepatitis B. INNO-LiPA assays and HBV DNA sequencing were used to determine HBV genotypes, mutations in the core promoter and precore/core regions. After 16-weeks interferon-alpha treatment, the rate of HBeAg clearance was higher in genotype A versus all other genotypes (P = 0.014), or genotype D alone (P = 0.05). The HBV genome analysis revealed that: (i) after 16-weeks treatment, an HBV subpopulation with core promoter mutations emerged or increased (P < 0.001) only in genotype A; (ii) the core gene of genotype A has the lowest number of amino acid variations in comparison with genotypes B, C, or D. Logistic regression analysis identified genotype A as a positive predictor of short (16 weeks) treatment response (P = 0.001; odds ratio 6.19, 95 confidence interval 1.94-19.8), having a greater impact than baseline HBV DNA or alanine aminotransferase (ALT) levels. In contrast, the response to prolonged interferon-alpha treatment was not different between HBV genotypes. These results suggest that HBV genotype A responds earlier to interferon treatment than other genotypes, which is associated with its molecular characteristics. The optimal duration of interferon-based therapies in chronic hepatitis B may vary between different HBV genotypes.
Hou
Jinlin
J
Institute of Hepatology, University College London, London WC1E 6HX, UK.
Schilling
Ralf
R
Janssen
Harry L A
HL
Hansen
Bettina E
BE
Heijtink
Rudolf
R
Sablon
Erwin
E
Williams
Roger
R
Lau
George K K
GK
Schalm
Solko W
SW
Naoumov
Nikolai V
NV
D000328:Adult; D005260:Female; D016679:Genome, Viral; D005838:Genotype; D006513:Hepatitis B e Antigens / Q000097:blood / Q000235:genetics* / Q000378:metabolism*; D006515:Hepatitis B virus / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000821:virology*; D006801:Humans; D016898:Interferon-alpha / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011401:Promoter Regions, Genetic / Q000235:genetics; D014758:Viral Core Proteins / Q000235:genetics
D006513:Hepatitis B e Antigens; D016898:Interferon-alpha; D014758:Viral Core Proteins