Hepatitis B genotypes correlate with clinical outcomes in patients with chronic hepatitis B

TLDR

Six HBV genotypes (A–F) have been identified, but their pathogenic differences remain unknown. We investigated the prevalence of HBV genotypes in Taiwan and their association with liver disease severity in a cross‑sectional study. HBV genotypes were determined by a molecular method in 100 asymptomatic carriers and 170 patients with chronic liver disease and hepatocellular carcinoma. Genotype C predominated in cirrhosis and HCC patients over 50, while genotype B predominated in HCC patients under 50, especially those ≤35, suggesting genotype C links to severe disease and genotype B to early HCC. Additional large‑scale longitudinal studies are needed to confirm the relationship of HBV genotypes to liver disease severity and clinical outcomes (Gastroenterology 2000;118:554‑559).

Abstract

Background & Aims: Six genotypes (A–F) of hepatitis B virus (HBV) have been identified; however, the genotype-related differences in the pathogenicity of HBV remain unknown. Therefore, we investigated the prevalence of HBV genotypes in Taiwan and the association between distinct genotypes and severity of liver disease in a cross-sectional study. Methods: Using a molecular method, HBV genotypes were determined in 100 asymptomatic carriers and in 170 patients with histologically verified chronic liver disease and hepatocellular carcinoma (HCC). Results: All genotypes except genotype E were identified in Taiwan, and genotypes B and C were predominant. Genotype C was prevalent in patients with cirrhosis and in those with HCC who were older than 50 years compared with age-matched asymptomatic carriers (60% vs. 23%, P < 0.001, and 41% vs. 15%, P = 0.005, respectively). Genotype B was significantly more common in patients with HCC aged less than 50 years compared with age-matched asymptomatic carriers (80% vs. 52%, P = 0.03). This predominance was more marked in younger patients with HCC (90% in those aged ≤35 years), most of whom did not have cirrhosis. Conclusions: Our data suggest that HBV genotype C is associated with more severe liver disease and genotype B may be associated with the development of HCC in young Taiwanese. However, additional large-scale longitudinal studies are needed to confirm the relationship of HBV genotypes to liver disease severity and clinical outcomes.GASTROENTEROLOGY 2000;118:554-559