Discipline of Medicine, University of Queensland, Royal Brisbane Hospital, Brisbane, QLD, Australia.
J Viral Hepat. 2010 Sep;17(9):601-10. doi: 10.1111/j.1365-2893.2010.01326.x. Epub 2010 May 31.
Many studies have attested that not only does HBV genotype influence the outcome of the disease but it also influences the outcome of therapy with interferons and pegylated interferons, with genotype A doing better than genotype D in Caucasians and genotype B better than genotype C in Asians. However, the guidelines from three regional bodies - AASLD, APASL and EASL - all stop short of recommending genotyping as part of the management of chronic hepatitis B. The recommendations, however, from several national organizations as well as from individual reviewers suggest that genotyping is essential to detect patients in whom the use of pegylated interferon will give a high likelihood of response with a finite course of therapy and avoid the disadvantages of nucleoside analogues with their viral resistance. It is concluded that determination of HBV genotype should form part of the management in treating chronic hepatitis B.
许多研究已经证实，HBV 基因型不仅影响疾病的结局，还影响干扰素和聚乙二醇干扰素治疗的结局，在白种人中，基因型 A 的疗效优于基因型 D，在亚洲人中，基因型 B 的疗效优于基因型 C。然而，三个地区组织（AASLD、APASL 和 EASL）的指南都没有建议将基因分型作为慢性乙型肝炎管理的一部分。然而，一些国家组织和个别评论者的建议表明，基因分型对于检测那些使用聚乙二醇干扰素治疗有很高反应可能性且疗程有限的患者是至关重要的，可以避免核苷酸类似物的病毒耐药性的缺点。结论是，HBV 基因型的测定应作为治疗慢性乙型肝炎的管理的一部分。
