Hepatitis B virus genotype C is associated with more severe liver fibrosis than genotype B.

Abstract

BACKGROUND & AIMS:

Histologic analyses of liver fibrosis have been limited by small sample sizes and the predominance of samples from patients with active hepatitis.

METHODS:

We performed a prospective study of transient elastography in treatment-naive patients with chronic hepatitis B, to investigate the relationship between hepatitis B virus (HBV) genotype and liver fibrosis. A validated liver stiffness measurement algorithm was used to define insignificant fibrosis and advanced fibrosis.

RESULTS:

Of 1106 patients, 711 (64%) were older than age 40, 370 (34%) had positive test results for hepatitis B e antigen (HBeAg), and 386 (35%) had increased serum levels of alanine aminotransferase. Of the patients, 524 (49%) had genotype B and 582 (51%) had genotype C HBV infection. Patients with genotype C infection had insignificant fibrosis less often (42% vs 55%; P < .0001) and advanced fibrosis more often (25% vs 19%; P = .015) than those infected with genotype B HBV. The difference in the severity of liver fibrosis between the 2 HBV genotypes was most marked among patients older than age 40 and those who tested negative for HBeAg. The mean age of patients infected by genotype C was greater than that of patients infected by genotype B HBV (41 vs 36 y). Among patients who were older than age 40 and tested negative for HBeAg, those with genotype C infection had higher levels of HBV DNA and alanine aminotransferase than those with genotype B HBV.

CONCLUSIONS:

Genotype C HBV was associated with more severe liver fibrosis than genotype B HBV, probably because of delayed HBeAg seroconversion and prolonged active disease.

• Authors: Henry Lik-Yuen Chan, Grace Lai-Hung Wong, Chi-Hang Tse, Angel Mei-Ling Chim, Karen Kar-Lum Yiu, Hoi-Yun Chan, Joseph Jao-Yiu Sung, Vincent Wai-Sun Wong
• Journal: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association (Clin Gastroenterol Hepatol) Vol. 7 Issue 12 Pg. 1361-6 (Dec 2009) ISSN: 1542-7714 [Electronic] United States
• PMID: 19683072 (Publication Type: Journal Article)

Topics

• Adult
• Elasticity Imaging Techniques
• Female
• Genotype
• Hepatitis B virus (classification, genetics, isolation & purification)
• Hepatitis B, Chronic (pathology, virology)
• Humans
• Liver Cirrhosis (pathology, virology)
• Male
• Middle Aged
• Prospective Studies
• Severity of Illness Index