Ratnaparkhi Manisha M, Vyawahare Chanda R, Gandham Nageswari R
Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre and Dr. D. Y. Patil Vidyapeeth, Pune 411018, Mahārāshtra, India.
World J Exp Med. 2025 Jun 20;15(2):102395. doi: 10.5493/wjem.v15.i2.102395.
Hepatitis B virus (HBV) infection is still a major worldwide health concern, contributing to chronic liver disorders like hepatocellular carcinoma (HCC). This review comprehensively analyzes HBV genotype distribution, mutation patterns, and their clinical implications, focusing on diagnostic and therapeutic strategies for HBV-positive patients. The discussion begins with HBV virology, emphasizing its capacity for chronic hepatitis and its association with severe liver complications, notably HCC. Understanding HBV genotypes (A-J) and their distinct geographic distributions is crucial, as genotype variations influence disease progression and treatment responses. Genotypes like C are particularly linked to heightened HCC risk, highlighting the need for genotype-specific management strategies. The genomic structure of HBV, consisting of four open reading frames (ORFs) encoding essential viral proteins, is detailed, with emphasis on mutations within these ORFs influenced by host immune responses and antiviral therapies. These mutations contribute to viral resistance and virulence, impacting treatment outcomes through alterations in viral replication dynamics. Clinical implications are explored through genotype-specific impacts on disease outcomes and treatment approaches. Genotype and mutation analysis guide personalized treatment regimens, optimizing therapeutic efficacy while minimizing adverse effects and preventing drug resistance. Diagnostic molecular techniques such as polymerase chain reaction and sequencing are pivotal in genotype and mutation detection, facilitating tailored treatment decisions.
乙型肝炎病毒(HBV)感染仍然是全球主要的健康问题,可导致肝细胞癌(HCC)等慢性肝脏疾病。本综述全面分析了HBV基因型分布、突变模式及其临床意义,重点关注HBV阳性患者的诊断和治疗策略。讨论从HBV病毒学开始,强调其引发慢性肝炎的能力及其与严重肝脏并发症(尤其是HCC)的关联。了解HBV基因型(A - J)及其独特的地理分布至关重要,因为基因型变异会影响疾病进展和治疗反应。像C型这样的基因型与HCC风险升高尤其相关,凸显了采用基因型特异性管理策略的必要性。详细介绍了HBV的基因组结构,它由四个编码必需病毒蛋白的开放阅读框(ORF)组成,重点关注受宿主免疫反应和抗病毒治疗影响的这些ORF内的突变。这些突变导致病毒耐药性和毒力,通过改变病毒复制动态影响治疗结果。通过基因型对疾病结局和治疗方法的特异性影响来探讨临床意义。基因型和突变分析指导个性化治疗方案,在优化治疗效果的同时尽量减少不良反应并预防耐药性。聚合酶链反应和测序等诊断分子技术在基因型和突变检测中至关重要,有助于做出量身定制的治疗决策。