title: Change of hepatitis B virus genotypes in acute and chronic infections in Japan.
abstract: During 35 years from 1971 to 2005, 153 patients with acute and 4,277 with chronic HBV infection visited the Toranomon Hospital in Tokyo, Japan. They were grouped into seven 5-year periods, and HBV genotypes/subgenotypes were determined. Patients with acute HBV infection were younger (P = 0.046), predominantly male (P = 0.004), possessed higher alanine aminotransferase levels (P < 0.001), positive more frequently for HBeAg (P < 0.001), and had lower HBV DNA loads (P = 0.014) than those with chronic infection. Sexual transmission was more frequent in patients with acute than chronic HBV infection (67% vs. 3%, P < 0.001). The number of patients with acute infection increased throughout 1971-2005. Patients with chronic infection increased since 1971, peaked in 1986-1990 and then decreased. The number of patients increased since 1990-2000 again, however, reflecting recent boost of acute HBV infection. The distribution of HBV genotypes was considerably different between patients with acute and chronic infections (A, B, and C: 28.6%, 10.3%, and 59.5% vs. 3.0%, 12.3%, and 84.5%, respectively, P < 0.001). Since 1991, genotype A foreign to Japan started to increase sharply in patients with acute infection, and gradually in those with chronic infection. There was a trend for the foreign subgenotype B2/Ba to increase recently (P < 0.05). Despite immunoprophylaxis of high-risk babies born to carrier mothers with hepatitis B e antigen, implemented nationally since 1986, acute and chronic infections with HBV have been increasing in Japan. Based on genotypes/subgenotypes changing with time, the resurgence of hepatitis B could be attributed to infections, with foreign HBV genotypes/subgenotypes, spreading swiftly by sexual contact.
authors.affiliation: Research Institute for Hepatology, Toranomon Hospital, Tokyo, Japan. vj7m-kbys@asahi-net.or.jp
authors.forename: Mariko
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Kenji
authors.initials: K
authors.lastname: Ikeda
authors.forename: Yasuji
authors.initials: Y
authors.lastname: Arase
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Suzuki
authors.forename: Norio
authors.initials: N
authors.lastname: Akuta
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Hosaka
authors.forename: Hitomi
authors.initials: H
authors.lastname: Sezaki
authors.forename: Hiromi
authors.initials: H
authors.lastname: Yatsuji
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Sachiyo
authors.initials: S
authors.lastname: Watahiki
authors.forename: Rie
authors.initials: R
authors.lastname: Mineta
authors.forename: Satomi
authors.initials: S
authors.lastname: Iwasaki
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Miyakawa
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Kumada
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005838:Genotype; D006509:Hepatitis B / Q000453:epidemiology* / Q000821:virology*; D006515:Hepatitis B virus / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D014041:Tokyo