AASLD: Natural History of Hepatitis B Infection and Role of HBV Genotype

StephenW

AASLD: Natural History of Hepatitis B Infection and Role of HBV Genotype

Published on Tuesday, 20 December 2011 00:00
Written by Liz Highleyman



People with hepatitis B "e" antigen (HBeAg) positive and negative disease have different levels of hepatitis B surface antigen (HBsAg), variable extent of liver fibrosis, and different distribution of HBV genotypes, according to a study presented at the American Association for the Study of Liver Disease (AASLD) Liver Meeting last month in San Francisco.

While the importance of viral genotypes and human IL28B gene patterns has been well established for hepatitis C virus (HCV) infection, their influence on the course of hepatitis B virus (HBV) infection has not been well studied.

In this natural history study, Michelle Martinot-Peignoux from Université de Paris and colleagues looked at the relationship between HBV genotype, HBeAg status, HBsAg levels, HBV DNA viral load, IL28B (rs12979860) pattern, and severity of liver disease in a cohort of patients infected with HBV genotypes A, B, C, D, or E.

The analysis included 374 treatment-naive chronic hepatitis B patients assessed at the university hospital between 2000 and 2008. Participants had known HBeAg status and were scheduled to undergo liver biopsy. People with HCV, hepatitis delta (HDV), or HIV were excluded.

Results

    97 patients were HBeAg positive and 277 were HBeAg negative.
    Among HBeAg positive participants, 27% had HBV genotype A, 9% had genotype B, 29% had genotype C, 15% had genotype D, and 20% had genotype E.
    Among HBeAg negative patients, the corresponding frequencies were 25%, 12%, 2%, 28%, and 33%, respectively.
    Among HBsAg positive people, 49% had the IL28B CC pattern (associated with favorable interferon responsiveness in patients with HCV), 33% had the mixed CT pattern, and 18% had the TT pattern.
    Among HBeAg negative people, the distribution was 41%, 33%, and 26%, respectively.
    HBV DNA levels were 2 to 3 log IU/mL higher among HBeAg positive patients compared with HBeAg negative patients, but within these groups viral load did not differ significantly according to HBV genotype.
    Average HBsAg levels were also higher among HBeAg positive compared with HBeAg negative patients, regardless of HBV genotype.
    However, within the HBeAg negative group, the mean HBsAg level was significantly lower among people with HBV genotype B.
    Within the HBeAg positive group, HBV genotype A was associated with more advanced fibrosis, half of those with severe liver disease carried this genotype.

"HBsAg and HBV DNA levels were lower in HBeAg [negative] patients than in HBeAg [positive] patients regardless of HBV genotype," the investigators concluded. "In HBeAg [positive] patients, advanced fibrosis was associated with a lower HBsAg levels and infection with HBV genotype A. The IL28B genotype CC was underrepresented in patients infected with genotype E."

Investigator affiliations: INSERM U-773, Centre de Recherche Biomédicale Bichat-Beaujon, Université Paris VII, Clichy, France; Service d’Hépatologie, Hôpital Beaujon, Clichy, France.

12/20/11

Reference

M Martinot-Peignoux, M Lapalus, O Lada, et al. Natural history of hepatitis B virus (HBV) infection: role of HBV genotypes (A to E) assessed in a large cohort. 62nd Annual Meeting of the American Association for the Study of Liver Disease (AASLD 2011). San Francisco, November 4-8. 2011. Abstract 506.

StephenW

AASLD：乙型肝炎病毒感染和HBV基因型的作用的自然历史

分类：B型肝炎
    发布于2011年12月20日（星期二）00:00
    书面LIZ Highleyman



乙“E抗原（HBeAg）阳性和阴性肝炎的人​​有不同层次的乙肝表面抗原（HBsAg），可变程度的肝纤维化，HBV基因型的不同分布，根据美国协会提交的一项研究肝病（AASLD）肝会议上个月在旧金山的研究。

虽然病毒基因型和人类IL28B的基因模式的重要性已建立丙型肝炎病毒（HCV）感染，乙型肝炎病毒（HBV）感染的过程中的影响力没有得到很好的研究。

在此自然史研究中，米歇尔从巴黎大学和他的同事马天瑞Peignoux看着HBV基因型之间的关系，HBeAg的状态的队列中，乙肝表面抗原，HBV DNA病毒载量水平，IL28B（rs12979860）模式，和肝脏疾病的严重程度患者感染HBV基因型A，B，C，D或E

该分析包括374天真治疗慢性乙型肝炎在大学医院的评估2000年和2008年之间的患者。与会者们称为HBeAg的状态，并计划进行肝活检。与丙型肝炎病毒，丁型肝炎（HDV）的，或艾滋病毒的人被排除在外。

结果

    97例HBeAg阳性和277 HBeAg阴性。
    C基因型HBeAg阳性的参与者之间，27％的HBV A基因型，9％的B型，29％，15％，基因型D，基因型大肠杆菌和20％
    HBeAg阴性患者之间，对应的频率分别为25％，12％，2％，28％和33％。
    HBsAg阳性的人当中，49％的IL28B CC模式（有利丙型肝炎患者干扰素响应），33％的CT混合模式，和18％的TT模式。
    HBeAg阴性的人之间，分布，分别为41％，33％和26％。
    HBV DNA水平高出2至3日志IU / ML e抗原阳性患者与HBeAg阴性患者相比，但这些群体内的病毒载量没有显着差异，根据HBV基因型。
    HBeAg阳性与HBeAg阴性患者，无论HBV基因型相比之间，平均HBsAg水平也较高。
    然而，在HBeAg阴性组，平均HBsAg水平明显降低HBV基因型B的人
    在HBeAg阳性组，HBV基因型一个更先进的肝纤维化相关，严重的肝脏疾病的一半，携带这种基因型。

“HBsAg和HBV DNA水平，HBeAg的[负面]比[积极]的患者，无论HBeAg的HBV基因型患者低，研究人员得出结论。” “在HBeAg [积极]患者，晚期肝纤维化是与较低的HBsAg水平与HBV基因型A.感染IL28B基因型CC基因型大肠杆菌感染的患者人数不足”

调查背景：中心DE RECHERCHE Biomédicale Bichat Beaujon，巴黎第七大学，克利希，法国，德Hépatologie服务，医院的Beaujon，克利希，法国INSERM的U - 773。

11年12月20日

参考

中号马天瑞- Peignoux，男Lapalus，澳，拉达，等。乙型肝炎病毒（HBV）感染的自然史：HBV基因型的作用（A至E）评估在一个大的队列。美国协会第62届年会肝病（AASLD 2011）的研究。旧金山年11月4-8。 2011年。摘要506。