Pediatric Liver Disease Therapy and Research Center, Beijing 302 Hospital, Beijing, China.
BMC Infect Dis. 2011 Sep 30;11:262. doi: 10.1186/1471-2334-11-262.
The association of hepatitis B virus (HBV) genotypes/subgenotypes with clinical characteristics is increasingly recognized. However, the virologic and clinical features of HBV genotypes/subgenotypes in pediatric patients remain largely unknown.
Four hundred and eighty-seven pediatric inpatients with CHB were investigated, including 217 nucleos(t)ide analog-experienced patients. HBV genotypes/subgenotypes and reverse transcriptase (RT) mutations were determined by direct sequencing. The stage of fibrosis and degree of inflammatory activity were evaluated by the Metavir score system.
Among 487 enrolled pediatric patients, HBV genotype C2 and B2 were the most two prevalent (73.7% and 21.1%). Comparing with HBV/B2 infected patients, no significant difference was observed in the incidence rate and mutant patterns of lamivudine- or adefovir-resistant mutations in HBV/C2 infected patients (P > 0.05). Importantly, we found that the degree of hepatic inflammation degree, fibrosis stage and ALT level were significantly higher in HBV/C2-infected HBeAg positive patients than it was in HBV/B2-infected ones.
The pediatric patients with HBV/C2 infection might be more susceptible to develop severe liver pathogenesis.
乙型肝炎病毒(HBV)基因型/亚型与临床特征的相关性越来越受到重视。然而,HBV 基因型/亚型在儿科患者中的病毒学和临床特征仍知之甚少。
对 487 例慢性乙型肝炎住院患儿进行了研究,包括 217 例核苷(酸)类似物治疗经验患者。通过直接测序确定 HBV 基因型/亚型和逆转录酶(RT)突变。采用 Metavir 评分系统评估纤维化分期和炎症活动度。
在 487 例入组的儿科患者中,HBV 基因型 C2 和 B2 最为常见(分别为 73.7%和 21.1%)。与 HBV/B2 感染患者相比,HBV/C2 感染患者拉米夫定或阿德福韦酯耐药突变的发生率和突变模式无显著差异(P>0.05)。重要的是,我们发现 HBeAg 阳性的 HBV/C2 感染患者的肝炎症程度、纤维化分期和 ALT 水平明显高于 HBV/B2 感染患者。
HBV/C2 感染的儿科患者可能更容易发生严重的肝脏发病机制。