Significance of Hepatitis B Genotype in Acute Exacerbation, Hbeag Seroconversion, Cirrhosis–Related Complications, and Hepatocellular Carcinoma

作者：Man-Fung Yuen, Erwin Sablon, He‐Jun Yuan, Danny Ka‐Ho Wong, Chee‐Kin Hui, Benjamin Chun–Yu Wong, Annie On On Chan, Ching‐Lung Lai · 发表于：Hepatology · 年份：2003 · DOI：10.1053/jhep.2003.50098 · 被引用次数：158 · 研究领域：Hepatitis B Virus Studies、Hepatitis C virus research、Liver Disease Diagnosis and Treatment

The pathologic role of hepatitis B virus (HBV) genotype in Chinese patients with HBV infection is largely unknown. We examined the relationship between HBV genotypes, and hepatitis B e antigen (HBeAg) seroconversion, acute exacerbation, cirrhosis-related complications, and precore/core promoter mutations. Three hundred forty-three HBV patients (288 were asymptomatic, 55 presented with cirrhosis-related complications) were recruited. HBV genotypes and precore/core promoter mutations were determined by line probe assays. Genotypes B and C were the 2 most common genotypes, contributing 28% and 60%, respectively. The median age of HBeAg seroconversion for patients with genotype B was 9 years earlier than patients with genotype C (P =.011). There were no differences in the liver biochemistry, HBV DNA level, and cumulative risk of acute exacerbation (defined as increased alanine aminotransferase level > or =1.5 x upper limit of normal) between patients with genotypes B and C. There was a trend for patients with genotype B to have a higher cumulative rate of HBeAg seroconversion compared with patients with genotype C at the initial follow-up of 6 years (P =.053), but this difference became insignificant during subsequent follow-up. The prevalence of both genotypes was the same in patients with and without cirrhosis-related complications and/or hepatocellular carcinoma. Genotype B was associated with precore mutations (P <.0001), whereas genotype C was associated with core promoter m...