The clinical implications of hepatitis B virus genotype: Recent advances
Journal
Journal of Gastroenterology and Hepatology (Australia)
Journal Volume
26
Journal Issue
SUPPL. 1
Pages
123-130
Date Issued
2011
Author(s)
Lin C.-L.
Abstract
Outcomes of chronic hepatitis B virus (HBV) infection are heterogeneous. Estimates of annual incidence of cirrhosis and hepatocellular carcinoma (HCC) are 2-10% and 1-3%, respectively. Several viral factors, including HBV genotype, viral load and specific viral mutations, have been associated with disease progression. Among these, HBV genotype is not only predictive of clinical outcomes but has also been associated with response to interferon treatment. Currently, at least 10 HBV genotypes and several subtypes have been identified; they have distinct geographic distribution. Acute infection with genotypes A and D results in higher rates of chronicity than genotypes B and C. Compared to genotype A and B cases, patients with genotypes C and D have lower rates of spontaneous hepatitis B e antigen (HBeAg) seroconversion; when this occurs, it tends to be delayed. HBV genotype C has a higher frequency of basal core promoter (BCP) A1762T/G1764A mutation, pre-S deletion and is associated with higher viral load than genotype B. Similarly, genotype D has a higher prevalence of BCP A1762T/G1764A mutation than genotype A. These observations suggest important pathogenic differences between HBV genotypes. These may contribute to more severe liver disease, including cirrhosis and HCC with genotypes C and D HBV infection. In addition, genotype A and B patients have better responses to interferon-based therapy than genotypes C and D, but there are few consistent differences for direct HBV antivirals. In conclusion, genotyping of chronic HBV infections can help practicing physicians identify those at risk of disease progression and determine optimal anti-viral therapy. ? 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.
Subjects
Chronic hepatitis B; Cirrhosis; Genotype; HBV viral mutation; Hepatitis B virus (HBV); Hepatocellular carcinoma; Interferon-based therapy
SDGs
Other Subjects
alpha interferon; hepatitis B(e) antigen; lamivudine; nucleoside; nucleoside derivative; peginterferon alpha; telbivudine; virus DNA; antiviral therapy; chronic hepatitis; chronicity; controlled study; disease course; gene interaction; gene mutation; genetic difference; genotype; geographic distribution; hepatitis B; Hepatitis B virus; human; liver cell carcinoma; liver cirrhosis; liver disease; low drug dose; mutation rate; nonhuman; outcome assessment; priority journal; promoter region; review; risk assessment; seroconversion; treatment response; virus identification; virus load; virus mutant; virus pathogenesis; virus transmission; virus typing
Publisher
Blackwell Publishing
Type
review