Genotype impact on long-term virological outcome of chronic hepatitis B virus infection
基因型对慢性乙肝的影响
肝胆速递：HBV基因型A，B和D型的DNA载量可随时间逐渐下降，但高复制的C或者D型常常持续高复制
Genotype impact on long-term virological outcome of chronic hepatitis B virus infection
Sebastian Malmström ,
Anders Eilard ,
Simon B. Larsson ,
Charles Hannoun ,
Gunnar Norkrans ,
Magnus Lindhemail address
Department of Infectious Diseases, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Received 14 December 2011; received in revised form 22 February 2012; accepted 17 April 2012. published online 21 May 2012.
Abstract
Background
The importance of hepatitis B virus (HBV) genotype on the clinical course of chronic HBV infection is not yet clarified.
Objectives
To investigate genotype impact on long-term virological outcome of chronic HBV infection.
Study design
HBsAg, HBeAg, ALT and HBV DNA levels were determined after a median of 9.2years of follow-up of 124 adults with chronic HBV infection, of whom 33 were HBeAg-positive at inclusion.
Results
HBV DNA levels decreased significantly in patients carrying genotype A (n=28), B (n=21) or D (n=63), but not in those with genotype C infection (n=12). Loss of HBeAg was seen in 44% (4/9) of patients with genotype C, as compared with 92% (22/24) with non-C genotypes. Loss of HBsAg was seen in 36% (10/28) patients with genotype A, 5% (1/21) with B, 0% (0/12) with C, and 11% (7/63) with genotype D.
Conclusions
HBV DNA levels decreased over time in patients infected with genotypes A, B or D. However, highly active genotype C or D infection often remained highly active, implying a risk for progressive liver damage.