https://scholars.lib.ntu.edu.tw/handle/123456789/144529
標題: | B型肝炎病毒基因型和病毒基因體變異與肝細胞癌發生之相關性研究 | 作者: | 高嘉宏 | 關鍵字: | chronic hepatitis B, hepatitis B virus, hepatocellular carcinoma, genotype, genomic variation. | 公開日期: | 2004 | 出版社: | 臺北市:國立臺灣大學醫學院臨床醫學研究所 | 摘要: | 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 molecular virological mechanisms contributing these clinical differences, especially hepatocarcinogenesis, deserve further exploration. In this study, we therefore investigated the prevalence of specific mutations of HBV genome in a cohort of genotype B or C-infected hepatitis B carries in different stages of chronic liver disease and its risk associated with the development of HCC. Our data showed that both HBV genotype C and basal core promoter mutant were independent factors for HCC development. Therefore different HBV genotypes and viral mutants may have different contribution to the pathogenesis of HBV infection. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/27498 | 其他識別: | 922314B002136 | Rights: | 國立臺灣大學醫學院臨床醫學研究所 |
顯示於: | 臨床醫學研究所 |
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922314B002136.pdf | 77.51 kB | Adobe PDF | 檢視/開啟 |
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