Is hepatitis B virus genotype C independently associated with cirrhosis?

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<http://www.eurekalert.org/pub_releases/2010-02/wjog-ihb020910.php>

Public release date: 9-Feb-2010
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Contact: Ye-Ru Wang
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World Journal of Gastroenterology

Is hepatitis B virus genotype C independently associated with cirrhosis?

Hepatitis B virus (HBV) genotypes have distinct geographical distributions,
and have been shown to differ with regard to clinical outcome and prognosis.
However, the relationship between HBV genotypes and liver cirrhosis remains
controversial and no study on exploring the association between HBV genotypes
and subclinical cirrhosis in community-based population has been reported.
A research article to be published on January 21, 2010 in the World Journal of
Gastroenterology addresses this question. The research team led by Prof. Cao
from Department of Epidemiology, Second Military Medical University performed
a large epidemiological study with 10 167 community-based residents at the age
between 6 and 72 years in Eastern China. After excluding the subjects
co-infected with hepatitis C or hepatitis D viruses, the hepatitis B surface
antigen (HBsAg)-positive subjects were examined for HBV genotype, serum viral
load, alanine aminotransferase (ALT), hepatitis B e antigen (HBeAg) status,
and ultrasonographic changes. Logistic regression models were used to
determine the factors independently associated with probable cirrhosis.
Of 634 HBsAg-positive subjects with HBV genotyped, 82 had probable cirrhosis.
Probable cirrhosis was only found in the HBeAg-negative subjects, and more
frequent in the subjects with genotype C than in those with genotype B. In
HBeAg-negative subjects, high viral load was frequently associated with
abnormal ALT level, while ALT abnormality was more frequent in those with
probable cirrhosis than those without. Ultrasonographic fatty liver was not
found in the subjects with probable cirrhosis. HBV genotype C, age (≥ 45
years), male sex, and ALT abnormality were demonstrated to be major risk
factors of probable cirrhosis for the residents chronically infected with HBV.
Clinical relevance and public health importance of HBV genotypes are different
in a given population. HBV genotype B and C are major HBV genotypes endemic in
East Asia. HBV genotype B is associated with acute hepatitis and tends to be
self-limiting and shorter lived. However, genotype C is associated with longer
duration of liver damage in the HBeAg-negative subjects, which may be the main
reason for liver cirrhosis. Genotype C HBV-infected male residents at the age
of 45 years or older should be routinely examined for active hepatitis and
early cirrhosis. Early intervention to the HBV-infected subjects with high
risks of cirrhosis might be effective for decreasing overall mortality of
liver cirrhosis.
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HBV infection is a serious public health problem. Approximately 2 billion
people worldwide have been exposed to HBV, and more than 300 million are
chronically infected with HBV. Chronic HBV infection is the most important
risk factor of liver cirrhosis and hepatocellular carcinoma in HBV endemic
areas.
Second Military Medical University is one of the top comprehensive medical
research and education institution in China. It contains Basic Medical School,
Pharmacology School, Nursing School, Chinese Traditional Medicine School, Navy
Medical School, Preventive Medicine Branch, and three affiliated hospitals
(clinical medical colleges).
Reference: Yin JH, Zhao J, Zhang HW, Xie JX, Li WP, Xu GZ, Shen J, Dong HJ,
Zhang J, Wang L, Han JK, Wang HY, Cao GW. HBV genotype C is independently
associated with cirrhosis in community-based population. World J Gastroenterol
2010; 16(3): 379-383
http://www.wjgnet.com/1007-9327/16/379.asp

Correspondence to: Dr. Guang-Wen Cao, Professor of Medicine, Chairman,
Department of Epidemiology, Second Military Medical University, 800 Xiangyin
Rd., Shanghai 200433, China. [email protected]
Telephone: +86-21-81871060 Fax: +86-21-81871060

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