title: Role of hepatitis B virus genotype mixture, subgenotypes C2 and B2 on hepatocellular carcinoma: compared with chronic hepatitis B and asymptomatic carrier state in the same area.
abstract: The role of genotype mixture and subgenotypes remains controversial in determining the clinical outcome of chronic hepatitis B virus (HBV) infection. We aimed to determine their role on the development and the recurrence of hepatocellular carcinoma (HCC). HBV genotypes, serum viral load and hepatitis B e antigen (HBeAg) seroconversion were determined in 462 HCC patients, 234 chronic hepatitis patients and 425 asymptomatic carriers born in Eastern China. In the 462 HCC patients, 62 (13.4%), 337 (72.9%) and 49 (10.6%) had HBV subgenotype B2, C2 and genotype mixture, respectively. Genotype mixture in HCC patients and hepatitis patients was associated with higher viral load than HBV C2 (P = 0.012, P = 0.000) and more frequent than asymptomatic carriers (P = 0.005, P = 0.000). HBV C2 was more prevalent in HCC patients compared with controls. Proportion of HBV B2 in HCC patients decreased consecutively from <30 to 50-59 years group (P = 0.024). Age-related changes of HBeAg seroconversion were not consistent with serum viral load in HCC patients with HBV B2 and genotype mixture, quite in contrast to hepatitis patients. By multivariate regression analysis, age >or=40 years and serum viral load (>or=10 000 copies/ml) were independently associated with hepatocarcinogenesis, whereas age <or=50 years and HBV B2 were independently associated with HCC recurrence after surgical resection. In conclusion, HBV coinfections with two or three genotypes were associated with higher viral load and more severe course of the disease. HBV B2 infection was related to HCC recurrence. HBV C2 predominance in HCC patients was related to the high prevalence in Eastern China.
authors.affiliation: Department of Epidemiology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, People's Republic of China.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Yin
authors.forename: Hongwei
authors.initials: H
authors.lastname: Zhang
authors.forename: Chengzhong
authors.initials: C
authors.lastname: Li
authors.forename: Chunfang
authors.initials: C
authors.lastname: Gao
authors.forename: Yongchao
authors.initials: Y
authors.lastname: He
authors.forename: Yujia
authors.initials: Y
authors.lastname: Zhai
authors.forename: Peng
authors.initials: P
authors.lastname: Zhang
authors.forename: Ling
authors.initials: L
authors.lastname: Xu
authors.forename: Xiaojie
authors.initials: X
authors.lastname: Tan
authors.forename: Jinsong
authors.initials: J
authors.lastname: Chen
authors.forename: Shuqun
authors.initials: S
authors.lastname: Cheng
authors.forename: Stephan
authors.initials: S
authors.lastname: Schaefer
authors.forename: Guangwen
authors.initials: G
authors.lastname: Cao
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000821:virology*; D002353:Carrier State; D002681:China / Q000453:epidemiology; D004279:DNA, Viral; D005260:Female; D005838:Genotype; D006514:Hepatitis B Surface Antigens / Q000378:metabolism; D006513:Hepatitis B e Antigens / Q000378:metabolism; D006515:Hepatitis B virus / Q000145:classification / Q000235:genetics* / Q000472:pathogenicity; D019694:Hepatitis B, Chronic; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology* / Q000473:pathology; D011379:Prognosis; D012307:Risk Factors; D019562:Viral Load
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens