高嘉宏2006-07-262018-07-062006-07-262018-07-062004http://ntur.lib.ntu.edu.tw//handle/246246/27497Hepatitis 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.application/pdf75147 bytesapplication/pdfzh-TW國立臺灣大學醫學院臨床醫學研究所chronic hepatitis B, hepatitis B virus, genotype, recombination.[SDGs]SDG3journal articlehttp://ntur.lib.ntu.edu.tw/bitstream/246246/27497/1/922314B002135.pdf