title: HBV genotypes in India: do they influence disease severity?
abstract: OBJECTIVE
  Association of HBV genotypes (especially A and D) with severity of liver disease is controversial. We studied the influence of HBV genotypes on liver disease severity among Indian patients.
  
  
  METHODS
  We selected 247 HBV infected patients (42 acute hepatitis, 87 carriers, 44 chronic hepatitis B [CHB], 35 liver cirrhosis [LC] and 40 hepatocellular carcinoma [HCC]). Genotyping of stored sera was performed using genotype-specific enzyme-linked immunosorbent assay (ELISA) and restriction fragment length polymorphism (RFLP). The distribution of genotypes in disease states of differing clinical, histological and biochemical severity were compared.
  
  
  RESULTS
  The most common genotype was D (162/237, 68.3%), followed by A (61, 25.7%) and C (14, 5.9%). The distribution of HBV genotypes between patients with acute hepatitis and CHB (carriers + CHB + LC + HCC), or between carriers and disease states (CHB + LC + HCC), or between mild chronic infection (carriers + CHB) and complications of chronic HBV infection (LC + HCC) was similar. Eighty-seven patients had liver biopsy; the median histological activity index (HAI) and fibrosis stage at baseline were similar between genotype groups (four [1-9] genotype A [n = 28]), three (2-4) genotype C (n = 4) and four (1-10) genotype D (n = 55); P = 0.33 for HAI score; (0.5 [0-6] genotype A, 0.5 [0-4] genotype C and 1 [0-6] genotype D; P = 0.92 for fibrosis stage). The response to therapy was similar between the genotypes.
  
  
  CONCLUSIONS
  Clinical, histological severity and therapeutic responses are similar among patients with HBV genotypes A and D.
authors.affiliation: Department of Gastroenterology, All india Institute of Medical Sciences, New Delhi, India.
authors.forename: Kaushal
authors.initials: K
authors.lastname: Madan
authors.forename: Yogesh
authors.initials: Y
authors.lastname: Batra
authors.forename: Vishnubhatla
authors.initials: V
authors.lastname: Sreenivas
authors.forename: Masashi
authors.initials: M
authors.lastname: Mizokami
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Sreenivasa Baba
authors.initials: SB
authors.lastname: Chalamalasetty
authors.forename: Subrat K
authors.initials: SK
authors.lastname: Panda
authors.forename: Subrat K
authors.initials: SK
authors.lastname: Acharya