The Clinical Implications of Hepatitis B Virus Genotype: Recent Advances
Resource
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY v.26 SUPPL. 1 pp.123-130
Journal
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
Journal Volume
v.26
Journal Issue
1
Pages
123-130
Date Issued
2011
Date
2011
Author(s)
LIN, CHIH-LIN
KAO, JIA-HORNG
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 A 1762T/ 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.
Subjects
chronic hepatitis B
cirrhosis
genotype
HBV viral mutation
hepatitis B virus HBV
hepatocellular carcinoma
interferon-based therapy
SDGs