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HBV Genotype Affects Hepatitis B Disease Progression and Outcomes

Hepatitis B virus (HBV) genotype influences long-term outcomes including viral clearance, according to a Swedish study reported in the May 18, 2012, advance edition of the Journal of Clinical Virology. Genotype C in particular appears to be associated with more aggressive disease.

It is well known that genotype is a major determinant of treatment response for people with hepatitis C, although it does not seem to have much influence on disease severity. In contrast, the influence of genotype in people with hepatitis B is not well understood.

Sebastian Malmström from the University of Gothenburg and colleagues looked at the effect of genotype on long-term virological outcomes of chronic HBV infection.

The analysis included 124 adult chronic hepatitis B patients, 33 of whom were hepatitis B "e" antigen (HBeAg) positive at study entry. The HBV genotype distribution was 28 people with genotype A, 21 with genotype B, 12 with genotype C, and 63 with genotype D.

Participants were followed for a median of 9.2 years. The researchers determined patient genotypes and measured HBV DNA viral load, HBeAg, hepatitis B surface antigen (HBsAg), and alanine aminotransferase (ALT) levels.

Results

·      HBV DNA levels decreased significantly during follow-up among patients with genotypes A, B, or D, but not those with genotype C.

·      44% of people with genotype C experienced HBeAg loss, compared with 92% for those with other genotypes.

·      HBsAg loss was seen in 36% of patients with genotype A, 5% with genotype B, and 11% with genotype D, but none of those with genotype C.

"HBV DNA levels decreased over time in patients infected with genotypes A, B or D," the study authors concluded. "However, highly active genotype C or D infection often remained highly active, implying a risk for progressive liver damage."

6/15/12

Reference

S Malmström, A Eilard, SB Larsson, et al. Genotype impact on long-term virological outcome of chronic hepatitis B virus infection. Journal of Clinical Virology. May 18, 2012 (Epub ahead of print).