Clinical relevance of hepatitis B virus genotype in children with chronic infection and hepatocellular carcinoma
Clinical relevance of hepatitis B virus genotype in children with chronic infection and hepatocellular carcinoma
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DOI：
10.1053/j.gastro.2004.09.048
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发表时间：
2004-12-01
期刊：
影响因子：
29.4
通讯作者：
Chen, DS
中科院分区：
文献类型：
--
作者：
Ni, YH;Chang, MH;Chen, DS
背景和目标：本研究旨在探讨B型肝炎病毒（HBV）基因型对儿童慢性HBV感染和肝细胞癌（HCC）临床结局的影响。方法：对460例乙肝病毒携带儿童进行15年随访，其中26例为乙肝相关性肝癌。HBV基因分型在这些携带者儿童的入组和最近的随访以及HCC儿童的诊断时进行检查。病毒载量进行了检查，在登记的载体儿童。这些携带者根据其初始B e抗原（HBeAg）和抗B e抗原（抗-HBe）状态进行分组。根据随访期间是否发生自发性HBeAg血清转换，将HBeAg阳性（+）组进一步分为HBeAg（+/+）组和HBeAg（+/-）组。结果：HBeAg（+/+）、HBeAg（+/-）和抗-HBe（+）组中B基因型分别占73%、86%和76%。HBeAg（+/+）、HBeAg（+/-）和抗-HBe（+）组中C基因型分别为27%、8%和6%。C基因型携带者在HBeAg（+/+）组中的发生率高于其他两组（P = 0.01），与B基因型携带者相比，C基因型携带者的HBeAg血清转换延迟（P <0.001）。随访期间基因型变化很少（2.8%）。在HCC患者中，基因型B也是主要类型（74%）。基因型B和C之间的基线病毒载量没有差异。结论：虽然在台湾慢性HBV感染和HCC的儿童中HBV基因型B占主导地位，但基因型C延迟了儿童慢性HBV感染中HBeAg的血清转换。
Background & Aims: The aim of this study was to investigate the influence of hepatitis B virus (HBV) genotypes on the clinical outcome of chronic childhood HBV infection and hepatocellular carcinoma (HCC). Methods: A total of 460 HBV carrier children were followed-up for 15 years and 26 children with HBV-related HCC were recruited. HBV genotyping was examined at enrollment and the latest follow-up of these carrier children and at diagnosis in HCC children. Viral load was checked at enrollment for the carrier children. These carriers were grouped based on their initial hepatitis B e antigen (HBeAg) and antibody to hepatitis B e antigen (anti-HBe) status. The HBeAg positive (+) group was divided further into an HBeAg(+/+) group and HBeAg(+/-) group, depending on whether spontaneous HBeAg seroconversion occurred during the follow-up period. Results: Genotype B constituted 73%, 86%, and 76% in the HBeAg(+/+), HBeAg(+/-), and anti-HBe(+) groups, respectively. Genotype C was found in 27%, 8%, and 6% in the HBeAg(+/+), HBeAg(+/-), and anti-HBe(+) group, respectively. Genotype C carriers were more prevalent in the HBeAg(+/+) group than the other 2 groups (P = .01), and had a delayed HBeAg seroconversion compared with the genotype B carriers (P < .001). Changes of genotype during the follow-up period were rare (2.8%). In those with HCC, genotype B was also the major type (74%). There was no difference in the baseline viral load between genotypes B and C. Conclusions: Although HBV genotype B dominates in children with chronic HBV infection and HCC in Taiwan, genotype C delays HBeAg seroconversion in pediatric chronic HBV infection.