台灣地區B型肝炎病毒基因型B/C雜交病毒株之盛行率和臨床重要性
Date Issued
2004
Date
2004
Author(s)
高嘉宏
DOI
922314B002135
Abstract
Hepatitis B virus (HBV) infection is a major health problem in Taiwan.
Currently, 4 subtypes and 8 genotypes of HBV are identified worldwide, and
most of them have distinct geographic distributions. The impact of HBV
genotypes on the clinical outcome of chronic HBV infection in Taiwan has
been partially clarified. Our recent data showed that subtypes adw and adr or
genotypes B and C are the predominant HBV strains in Taiwan. In addition,
all adr strains are genotype C whereas 81% and 12% of the adw strains are
genotype B and genotype C, respectively. Clinically, genotype C is associated
with more severe liver disease including cirrhosis and hepatocellular
carcinoma (HCC) whereas genotype B is associated the development of HCC
in young non-cirrhotic patients. Serologically, genotype C tends to have a
higher frequency of hepatitis B e antigen (HBeAg) positivity and a higher
serum HBV DNA level than genotype B. Virologically, genotype C bears a
higher frequency of core promoter mutation than genotype B. Although
superinfection of HBV on top of hepatitis B carriers indeed occurs in Taiwan,
it is rarely associated with acute exacerbations. As to the response to antiviral
treatments, genotype C is associated with a lower response rate to interferon
therapy as compared to genotypes B. Although pathogenic and therapeutic
differences do exist among HBV genotypes in Taiwan, the relationship
between HBV genotypes and clinical phenotypes of patients with chronic
hepatitis B as well as the molecular virological mechanisms contributing these
clinical differences, especially hepatocarcinogenesis, deserve further
exploration. In addition, although the recombination between genotypes B
and C has been reported, its clinical relevance remains largely unknown. In
this study, we therefore investigated the prevalence of HBV genotype B/C
recombinant and its association with clinical phenotype of chronic hepatitis B
patients as well as progression of liver disease in Taiwan. Our results showed
that none of our HBV/B carriers were infected with HBV/Bj, and HBV/Ba
accounted for all of the HBV/B strains in Taiwan, irrespective of the severity
of liver disease. Therefore the discrepancy in genotype predominance
between HCC patients in Japan and Taiwan, particularly at a younger age,
remains to be elucidated.
Subjects
chronic hepatitis B, hepatitis B virus, genotype, recombination.
SDGs
Publisher
臺北市：國立臺灣大學醫學院臨床醫學研究所
Type
journal article
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