title: Hepatitis B virus genotype change in children is closely related to HBeAg/anti-HBe seroconversion.
abstract: OBJECTIVE
  Genotype changes have been observed during long-term follow-up in adults with chronic hepatitis B virus (HBV) infection. The aim of this study was to assess the frequency and distribution of HBV genotype shifts in treated and untreated European children during the different phases of chronic hepatitis B.
  
  
  METHODS
  The initial population consisted of 85 HBeAg-positive children who were sequentially investigated for HBV genotypes for a mean period of 7.1 years. During the survey, 65 patients seroconverted to anti-HBe and 24 received antiviral treatment. Genotyping was done by restriction fragment length polymorphism.
  
  
  RESULTS
  Genotypes at enrollment were distributed as follows: D (n = 67), A (n = 11), B (n = 4), and C and mixed (n = 3). A genotype change was observed in 16 (19%) participants at last visit, of whom 1 of 20 (5%) remained persistently HBeAg positive and 15 of 65 (23%) children had seroconverted to anti-HBe (P < 0.001). The genotype shift was D to A or B in 9 individuals, A to D in 5, and A to B in 1. Genotype changes were more frequent in untreated than in treated subjects; however, the difference was not statistically significant.
  
  
  CONCLUSIONS
  The results of this study suggest that genotype change is a relatively frequent event in children with chronic hepatitis B after anti-HBe seroconversion and independent of treatment. The reasons why only some patients will experience this event remain to be clarified.
authors.affiliation: Department of Pediatrics, HELIOS Medical Centre, Witten/Herdecke University, Wuppertal, Germany. stefan.wirth@helios-kliniken.de
authors.forename: Stefan
authors.initials: S
authors.lastname: Wirth
authors.forename: Flavia
authors.initials: F
authors.lastname: Bortolotti
authors.forename: Carl
authors.initials: C
authors.lastname: Brunert
authors.forename: Jan
authors.initials: J
authors.lastname: Postberg
authors.forename: Kai
authors.initials: K
authors.lastname: Hensel
authors.forename: Andreas
authors.initials: A
authors.lastname: Jenke
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D004279:DNA, Viral / Q000276:immunology*; D005060:Europe; D005260:Female; D005838:Genotype; D006510:Hepatitis B Antibodies / Q000097:blood*; D006513:Hepatitis B e Antigens / Q000097:blood / Q000235:genetics* / Q000276:immunology; D006515:Hepatitis B virus / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000097:blood / Q000188:drug therapy / Q000276:immunology* / Q000821:virology; D006801:Humans; D008297:Male; D012150:Polymorphism, Restriction Fragment Length
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006513:Hepatitis B e Antigens