Profile, spectrum and significance of HBV genotypes in chronic liver disease patients in the Indian subcontinent
Profile, spectrum and significance of HBV genotypes in chronic liver disease patients in the Indian subcontinent
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DOI：
10.1046/j.1440-1746.2002.02605.x
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发表时间：
2002-02-01
影响因子：
4.1
通讯作者：
Sarin, SK
中科院分区：
文献类型：
--
作者：
Thakur, V;Guptan, RC;Sarin, SK
背景与目的：某些乙型肝炎病毒（HBV）基因型据称与肝硬化和肝细胞癌（HCC）的发生以及中国台湾地区患者对干扰素治疗的反应有关。我们着手研究印度次大陆HBV基因型的流行情况及其意义。
方法：对130例经组织病理学证实的慢性HBV感染患者进行了研究，其中包括52例偶然发现的无症状乙肝表面抗原（HBsAg）阳性的慢性HBV感染个体（IDAHS，第I组）、48例肝硬化患者（第II组）和30例肝细胞癌（HCC，第III组）患者。采用限制性片段长度多态性以及对包括“a”决定簇区域在内的S基因进行直接测序来确定乙肝病毒基因型。
结果：在慢性HBV感染患者中仅发现基因型A（46%）和D（48%）。6%的患者存在基因型A和D的混合感染。在第I、II和III组患者中，基因型A分别占42%、48%和50%，基因型D分别占48%、50%和47%（P = 无显著性差异）。具有混合基因型的患者年龄明显更小（P < 0.05）。在第I组（IDAHS）感染基因型D的患者中，无一例组织学活动指数（HAI）≥4，而感染基因型A的患者中有53%（P < 0.05）。同样，基因型D与更严重的肝脏疾病相关（61%比30%，P < 0.05）。与IDAHS相比，基因型D在年龄<40岁的HCC患者中更为常见（63%比44%，P = 0.06）。
结论：（i）乙肝病毒基因型A和D在印度裔慢性肝病患者中普遍存在；（ii）HBV基因型D与更严重的疾病相关，并可能预测年轻患者中HCC的发生。（C）2001年布莱克威尔科学亚洲私人有限公司
Background and Aim: Certain hepatitis B virus (HBV) genotypes have been alleged to be associated with the development of cirrhosis and hepatocellular carcinoma (HCC), and the response to interferon therapy in Taiwanese patients. We undertook to study the prevalence and significance of HBV genotypes in the Indian subcontinent.Methods: One hundred and thirty histopathologically proven chronic HBV-infected patients, including 52 incidentally detected asymptomatic hepatitis B surface antigen (HBsAg)-positive subjects (IDAHS) with chronic HBV infection (group I), 48 cirrhotics (group II) and 30 hepatocellular carcinoma (HCC; group III) patients were studied. Hepatitis B virus genotypes were determined by using restriction fragment length polymorphism, and direct sequencing of the s gene including the 'a' determinant region.Results: Only genotypes A (46%) and D (48%) were found in the chronic HBV-infected patients. A mixed infection with genotypes A and D was seen in 6% of patients. Genotype A was found in 42, 48 and 50%, and genotype D in 48, 50 and 47% of group I, II and III patients, respectively (P = NS). The patients who had mixed genotypes were significantly younger (P < 0.05). In group I (IDAHS) patients infected with genotype D, none had a histological activity index (HAI) of 4 as compared to genotype A (53 vs 32%, P < 0.05). Similarly, genotype D was associated with more severe liver diseases (61 vs 30%, P < 0.05). Genotype D was more prevalent in HCC patients of < 40 years of age, as compared to IDAHS (63 vs 44%, P = 0.06).Conclusions: (i) Hepatitis B virus genotypes A and D are prevalent in chronic liver disease patients of Indian origin; and (ii) HBV genotype D is associated with more severe diseases and may predict the occurrence of HCC in young patients. (C) 2001 Blackwell Science Asia Pty Ltd.