Influence of hepatitis B virus genotypes on the progression of chronic type B liver disease

被引:426
作者
Sumi, H
Yokosuka, O
Seki, N
Arai, M
Imazeki, F
Kurihara, T
Kanda, T
Fukai, K
Kato, M
Saisho, H
机构
[1] Chiba Univ, Grad Sch Med, Dept Med & Clin Oncol, Chuou Ku, Chiba 2608670, Japan
[2] Chiba Univ, Grad Sch Med, Dept Funct Genom, Chiba 2608670, Japan
关键词
D O I
10.1053/jhep.2003.50036
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
To investigate the hepatitis B virus (HBV) genotype-related differences in the progression of liver disease, 585 patients with chronic HBV infection including 258 with histologically verified chronic liver disease (CLD) and 74 with hepatocellular carcinoma (HCC) were examined. The mean ages of both patients with advanced fibrosis (F3 or F4) and with HCC were significantly older in genotype B than in genotype C patients (P =.018, P =.024, respectively). Both the hepatitis B e antigen (HBeAg) negativity rate at biopsy and the cumulative HBe seroconversion rate in patients with CLD were significantly higher in genotype B patients than genotype C patients (P <.01, P =.022, respectively). Multivariate analysis revealed that genotype B, presence of precore mutation, high ALT levels, and severe histologic activity were independent factors for HBe seroconversion. Among all the biopsy-proven CLD patients, the ratio of patients with advanced fibrosis in genotype B was significantly lower than that in genotype C (4/30 vs. 74/224, respectively; P =.034). This difference was more remarkable in younger patients (≤45 years; 1/25 vs. 47/180, respectively; P =.020), and there was no difference in older patients (> 45 years). The distribution of each genotype between CLD and HCC was very similar (B and C: 11.2% and 87.0% vs. 10.8% and 89.2%, respectively). In conclusion, our results suggest that, although the patients with genotype B experience earlier HBe seroconversion, slower progression of liver fibrosis, and slower development of HCC, the life-long risk of progression to advanced fibrosis and development of HCC may not differ among genotypes B- and C-related chronic liver disease.
引用
收藏
页码:19 / 26
页数:8
相关论文
共 33 条
  • [1] ARAUZRUIZ P, 1997, J MED VIROL, V51, P1305
  • [2] CHRONIC HEPATITIS IN HBSAG-CARRIERS WITH SERUM HBV-DNA AND ANTI-HBE
    BONINO, F
    ROSINA, F
    RIZZETTO, M
    RIZZI, R
    CHIABERGE, E
    TARDANICO, R
    CALLEA, F
    VERME, G
    [J]. GASTROENTEROLOGY, 1986, 90 (05) : 1268 - 1273
  • [3] Hepatitis B e antigen-negative chronic hepatitis B in Hong Kong
    Chan, HLY
    Leung, NWY
    Hussain, M
    Wong, ML
    Lok, ASF
    [J]. HEPATOLOGY, 2000, 31 (03) : 763 - 768
  • [4] Hepatitis B virus infection and hepatocellular carcinoma: Molecular genetics and clinical perspectives
    Chen, PJ
    Chen, DS
    [J]. SEMINARS IN LIVER DISEASE, 1999, 19 (03) : 253 - 262
  • [5] Cytotoxic T cells and viral hepatitis
    Chisari, FV
    [J]. JOURNAL OF CLINICAL INVESTIGATION, 1997, 99 (07) : 1472 - 1477
  • [6] Hepatitis B virus genotype B is associated with earlier HBeAg seroconversion compared with hepatitis B virus genotype C
    Chu, CJ
    Hussain, M
    Lok, ASF
    [J]. GASTROENTEROLOGY, 2002, 122 (07) : 1756 - 1762
  • [7] DESMET VJ, 1994, HEPATOLOGY, V19, P1513, DOI 10.1002/hep.1840190629
  • [8] Hepatitis B virus genotype distribution among chronic hepatitis B virus carriers in Shanghai, China
    Ding, X
    Mizokami, M
    Yao, GB
    Xu, B
    Orito, E
    Ueda, R
    Nakanishi, M
    [J]. INTERVIROLOGY, 2001, 44 (01) : 43 - 47
  • [9] Rapid detection of genotypes and mutations in the pre-core promoter and the pre-core region of hepatitis B virus genome:: correlation with viral persistence and disease severity
    Grandjacques, C
    Pradat, P
    Stuyver, L
    Chevallier, M
    Chevallier, P
    Pichoud, C
    Maisonnas, M
    Trépo, C
    Zoulim, F
    [J]. JOURNAL OF HEPATOLOGY, 2000, 33 (03) : 430 - 439
  • [10] HADZIYANNIS SJ, 1983, HEPATOLOGY, V3, P656