Genoepidemiology and its relationship to clinical features in patients infected chronically with hepatitis B virus (HBV)

The route of hepatitis B virus (HBV) infection and subsequent clinical course vary widely. It is not clear if the prevalence of HBV genotypes differs in the different clinical features of HBV carriers. The genotype of HBV was determined by direct sequencing of HBV DNA amplified with a PCR method from 310 Japanese HBV carriers (189 male and 121 female, aged from 14 to 82 years). Genotype A was detected in eight (2.6%) of 310 HBV carriers, genotype B was detected in 92 (29.7%) and genotype C was detected in 210 (67.7%). None of them had genotype D, E or F. Among the eight patients infected with genotype A, one patient had been infected with HBV in his adulthood. Furthermore, both of one married couple also had genotype A. On the other hand, a HBeAg-negative state and HBeAg-negative healthy carrier state were significantly more common in patients infected with genotype B than those with genotype C by univariate analysis (P < 0.0001 and 0.0058) and multiple logistic regression (P < 0.0001 and 0.0029). Hepatocellular carcinoma was present in two of eight patients with genotype A, 11 of 210 patients with genotype C and none of the 92 patients with genotype B. These results suggest that the genotype of HBV may be a determinant of the outcome after acute HBV infection and of chronic HBV infection. (C) 2000 Elsevier Science Ireland Ltd.