Role of hepatitis B virus genotypes in chronic hepatitis B exacerbation

Hepatitis B virus (HBV) genotypes and precore and core promoter mutations were determined in 318 patients with HBV. Patients infected with HBV genotype B had a higher median alanine aminotransferase level and bilirubin level and a lower median albumin level during exacerbations of disease, compared with patients infected with HBV genotype C (all P < .001). By logistic regression analysis, HBV genotype B infection (P = .014) and low albumin levels (P = .006) were independently associated with a higher risk of hepatic decompensation during severe exacerbations of disease. Patients infected with genotype B had a significantly higher mortality due to hepatic decompensation than did patients with genotype C ( 70% vs. 27.8%; P = .05).