Influence of hepatitis B virus genotype on the long-term outcome of chronic hepatitis B in western patients
Influence of hepatitis B virus genotype on the long-term outcome of chronic hepatitis B in western patients
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DOI：
10.1053/gast.2002.37041
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发表时间：
2002-12-01
期刊：
影响因子：
29.4
通讯作者：
Rodés, J
中科院分区：
文献类型：
--
作者：
Sánchez-Tapias, JM;Costa, J;Rodés, J
背景与目的：本研究的目的是探讨慢性乙型病毒性肝炎的变异结局是否与乙肝病毒(HBV)基因型别有关。方法：对258例西班牙慢性乙型病毒性肝炎患者长期随访的临床和病毒学资料进行比较。结果：A、D、F型的患病率分别为52%、35%、7%。伴随的持续生化缓解和HBVDNA清除率，A-型高于D-型(14.2；P=0.002)或F型(4.2P=0.03)。A型肝炎患者的乙肝表面抗原(HBs)转阴率明显高于D型肝炎患者(对数列4.6，P=0.03)。COX回归分析显示，乙肝表面抗原持续缓解和清除与A型感染有关。抗-HBe血清转换率与HBV型无关，但A型肝炎患者的持续缓解率高于D型肝炎患者，无论是随访期间抗-HBe抗体阴转者(LOG-RAN4.5；P=0.03)还是基线抗-HBE阳性患者(LOG-RANK，6.66；P=0.009)。与肝病相关的死亡在F型肝炎中的发生率高于A型肝炎(P=0.02)或D型肝炎(P=0.002)。结论：感染A、D或F型乙肝病毒的慢性乙肝患者的长期预后不同。
Background & Aims: The aim of this study was to investigate if the variable outcome of chronic hepatitis B may be related to hepatitis B virus (HBV) genotype. Methods: The clinical and virologic events observed over prolonged follow-up in 258 Spanish patients with chronic hepatitis B infected with different genotypes of HBV were compared. Results: The prevalence of genotype A, D, and F was 52%, 35%, and 7%, respectively. Concomitant sustained biochemical remission and clearance of HBV DNA occurred at a higher rate in genotype A- than in genotype D- (log-rank, 14.2; P = 0.002) or genotype F-infected patients (log-rank, 4.2; P = 0.03). The rate of hepatitis B surface antigen (HBsAg) clearance was higher in genotype A than in genotype D hepatitis (log-rank, 4.6; P = 0.03). Sustained remission and clearance of HBsAg were associated with infection with genotype A by Cox regression analysis. Seroconversion to antibody to hepatitis B e antigen (anti-HBe) was unrelated to HBV genotype, but the rate of sustained remission after seroconversion was higher in genotype A than in genotype D hepatitis both in patients who seroconverted to anti-HBe during follow-up (log-rank, 4.5; P = 0.03) and in patients with positive anti-HBe at baseline (log-rank, 6.66; P = 0.009). Death related to liver disease was more frequent in genotype F than in genotype A (P = 0.02) or genotype D (P = 0.002) hepatitis. Conclusions: The long-term outcome of chronic hepatitis B is different in patients infected with HBV genotype A, D, or F.