Department of Gastroenterology, All india Institute of Medical Sciences, New Delhi, India.
Hepatol Res. 2009 Feb;39(2):157-63. doi: 10.1111/j.1872-034X.2008.00417.x.
Association of HBV genotypes (especially A and D) with severity of liver disease is controversial. We studied the influence of HBV genotypes on liver disease severity among Indian patients.
We selected 247 HBV infected patients (42 acute hepatitis, 87 carriers, 44 chronic hepatitis B [CHB], 35 liver cirrhosis [LC] and 40 hepatocellular carcinoma [HCC]). Genotyping of stored sera was performed using genotype-specific enzyme-linked immunosorbent assay (ELISA) and restriction fragment length polymorphism (RFLP). The distribution of genotypes in disease states of differing clinical, histological and biochemical severity were compared.
The most common genotype was D (162/237, 68.3%), followed by A (61, 25.7%) and C (14, 5.9%). The distribution of HBV genotypes between patients with acute hepatitis and CHB (carriers + CHB + LC + HCC), or between carriers and disease states (CHB + LC + HCC), or between mild chronic infection (carriers + CHB) and complications of chronic HBV infection (LC + HCC) was similar. Eighty-seven patients had liver biopsy; the median histological activity index (HAI) and fibrosis stage at baseline were similar between genotype groups (four [1-9] genotype A [n = 28]), three (2-4) genotype C (n = 4) and four (1-10) genotype D (n = 55); P = 0.33 for HAI score; (0.5 [0-6] genotype A, 0.5 [0-4] genotype C and 1 [0-6] genotype D; P = 0.92 for fibrosis stage). The response to therapy was similar between the genotypes.
Clinical, histological severity and therapeutic responses are similar among patients with HBV genotypes A and D.
HBV 基因型（尤其是 A 型和 D 型）与肝病严重程度的关联存在争议。我们研究了 HBV 基因型对印度患者肝病严重程度的影响。
我们选择了 247 例 HBV 感染患者（42 例急性肝炎、87 例携带者、44 例慢性乙型肝炎 [CHB]、35 例肝硬化 [LC] 和 40 例肝细胞癌 [HCC]）。使用基因型特异性酶联免疫吸附试验（ELISA）和限制性片段长度多态性（RFLP）对储存的血清进行基因分型。比较了不同临床、组织学和生化严重程度疾病状态下基因型的分布。
最常见的基因型是 D 型（162/237，68.3%），其次是 A 型（61 例，25.7%）和 C 型（14 例，5.9%）。急性肝炎和 CHB（携带者+CHB+LC+HCC）患者之间、携带者和疾病状态之间（CHB+LC+HCC）或轻度慢性感染（携带者+CHB）和慢性 HBV 感染并发症（LC+HCC）之间的 HBV 基因型分布相似。87 例患者进行了肝活检；基线时基因型组的中位组织学活动指数（HAI）和纤维化分期相似（基因型 A[4 例，28 例]组为 4 [1-9]，基因型 C[4 例，4 例]组为 3 [2-4]，基因型 D[55 例]组为 4 [1-10]；HAI 评分的 P = 0.33；纤维化分期为基因型 A[0.5 [0-6]，基因型 C[0.5 [0-4]和基因型 D[1 [0-6]]；P = 0.92）。治疗反应在基因型之间相似。
HBV 基因型 A 和 D 的患者临床、组织学严重程度和治疗反应相似。
