乙型肝炎病毒基因型和临床疗效之间的相关性

StephenW

Jpn J Infect Dis. 2012;65(6):476-82.

Correlation between Hepatitis B Virus Genotypes and Clinical Outcomes.

Qingdao YH Virus Institute.

Abstract

Hepatitis B virus (HBV) has been classified into 10 genotypes (A-J)
according to genome sequence divergence. HBV genotypes have a distinct
geographical distribution. As chronic HBV infection is endemic in the Asian
region, genotypes B and C prevail there, and genotypes A and D are mainly
found in the western world and Europe. Genotypes A, B, C, and D have been
studied most extensively. In Europe and Asia, most patients with genotypes
A and B have acute hepatitis B; however, some mutants may tend to cause
fulminant hepatitis B. Many studies have indicated that the severity and
outcomes of chronic hepatitis B infections are more serious in patients
with genotypes C and D than in those with genotypes A and B. Cirrhosis and
hepatocellular carcinoma (HCC) are more frequently diagnosed in carriers of
genotypes C and D than in those of genotypes A and B. Accumulating
evidence indicated that higher plasma HBV DNA levels, infection with HBV
genotype C, as well as mutations at 1653T, 1753V, and A1762T/G1764A are
independently associated with the risk of HCC in Asian men. However, the
therapeutic responses differ with regard to the different HBV genotypes.
For example, the response to interferon-α treatment in patients with
genotypes A and B was better than that in patients with genotypes C, D, and
mixed genotypes. Some studies have shown seroconversion after treatment,
i.e., genotypes A and C may switch to genotypes D and B, respectively. Some
reports indicated a correlation between the emergence of the hepatitis B e
antigen-negative variant in patients with genotypes C and D and worsening
of liver injury without sustained response. In order to provide better
treatment options for these poorly responding patients, further studies,
e.g, novel immunomodulatory therapies, are required. Many studies have
shown that HBV genotypes have remarkable clinical and epidemical
differences; however, HBV sub-genotypes, mixed genotype infections, and the
effect of different genotypes on the treatment of HBV infections require
further studies.

StephenW

JPN感染。 2012年，65（6）:476-82。

乙型肝炎病毒基因型和临床疗效之间的相关性。

青岛YH病毒研究所。

抽象

B型肝炎病毒（HBV）已被分类成10个基因型（AJ）
根据基因组序列差异。 HBV基因型有明显的
地理分布。由于慢性HBV感染流行在亚洲
区，B，C基因型为准，并基因型A和D是主要
在西方世界和欧洲。基因型A，B，C，和D
研究最为广泛。在欧洲和亚洲，大多数患者的基因型
A和B有急性B型肝炎，但是，一些突变体可能会造成
暴发性肝炎B.许多研究已表明的严重程度和
慢性B型肝炎感染的结果是更严重的患者
比基因型C和D基因型A和B肝硬化
在运营商的更频繁地诊断肝细胞癌（HCC）
基因型C和D比A和B累积的基因型
证据表明，较高的血浆HBV DNA水平，HBV感染
，C型和突变1653T，1753V，和A1762T/G1764A
独立相关性与亚洲男性肝癌的危险。然而，
对治疗的反应不同方面的不同HBV基因型。
例如，响应于α-干扰素治​​疗的患者
A，B基因型比这更好的患者基因型C，D，
混合基因型。一些研究表明，血清治疗后，
即，基因型A和C可以切换到D和B型，分别。一些
报告表明之间的相关性出现乙肝e
抗原阴性患者基因型C和D的变体和恶化
肝损伤，如果没有持续的响应。为了提供更好的
这些不良反应患者的治疗方案，进一步的研究，
例如，新型免疫调节疗法，是必需的。许多研究
表明，HBV基因型有显着的临床及流行病学
的差异，但是，HBV分型，混合型感染，及
不同基因型的HBV感染者的治疗效果要求
进一步的研究。

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