Hepatitis B virus genotypes in the United States: Results of a nationwide study
Hepatitis B virus genotypes in the United States: Results of a nationwide study
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DOI：
10.1016/s0016-5085(03)00895-3
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发表时间：
2003-08-01
期刊：
影响因子：
29.4
通讯作者：
Lok, ASF
中科院分区：
文献类型：
--
作者：
Chu, CJ;Keeffe, EB;Lok, ASF
背景与目的：乙型肝炎病毒（HBV）基因型可能与肝脏疾病的严重程度和治疗反应有关。这项全国性研究的目的是确定美国HBV基因型的患病率，以及HBV基因型与患者人口统计学、感染模式和临床状态之间的关系。方法：在美国17个肝脏中心1年期间共纳入694名连续慢性hbv感染患者。收集了人口统计学、临床和实验室数据。采用线探针法检测血清HBV基因分型、前启动子和核心启动子变异。结果：7种HBV基因型（A- g）全部检出，以基因型A和基因型C最为常见。HBV基因型的流行在美国不同地区是不同的。HBV基因型与种族之间存在很强的相关性。HBV基因型A在白人和黑人患者中普遍存在，而基因型B和C在亚洲患者中最常见。在美国、欧洲、远东和东南亚出生的患者中，主要的基因型分别是A、D、C和13。基因型A和C与乙型肝炎e抗原的较高流行率相关。27%的患者检测到preore变异，44%的患者检测到核心启动子变异。结论：我们的研究表明，由于来自HBV感染率高的国家的移民，美国HBV感染的流行病学可能随着时间的推移而发生变化。HBV基因型可能解释了慢性HBV感染患者疾病表现的异质性。
Background & Aims: Hepatitis B virus (HBV) genotypes may be related to severity of liver disease and treatment response. The aims of this nationwide study were to determine the prevalence of HBV genotypes in the United States and the association between HBV genotypes and patient demographics, mode of infection, and clinical status. Methods: A total of 694 consecutive chronic HBV-infected patients seen in 17 U.S. liver centers during a 1-year period were enrolled. Demographic, clinical, and laboratory data were collected. Sera were tested for HBV genotyping, precore, and core promoter variants by line-probe assays. Results: All 7 HBV genotypes (A-G) were found, with genotypes A and C the most common. The prevalence of HBV genotypes was different in different regions of the United States. A strong correlation was found between HBV genotypes and ethnicity. HBV genotype A was prevalent among white and black patients, whereas genotypes B and C were most common among Asian patients. The predominant genotype among patients born in the United States, Europe, the Far East, and Southeast Asia were A, D, C, and 13, respectively. Genotypes A and C were associated with a higher prevalence of hepatitis B e antigen. Precore variant was detected in 27% of patients and core promoter variant in 44% of patients. Conclusions: Our study suggests that the epidemiology of HBV infection in the United States may have changed over time as a result of immigration from countries with a high prevalence of HBV infection. HBV genotypes may account for the heterogeneity in disease manifestations among patients with chronic HBV infection.