Clinical–Liver, Pancreas, and Biliary TractInfluence of hepatitis B virus genotype on the long-term outcome of chronic hepatitis B in western patients☆,☆☆
Section snippets
Patients
From January 1985 to January 1998, 407 Spanish patients with asymptomatic or minimally symptomatic chronic hepatitis B were consecutively referred to the Liver Unit of the Hospital Clinic of Barcelona, Spain. All had a persistent or intermittent elevation of alanine aminotransferase serum levels and a positive test for hepatitis B surface antigen (HBsAg) in serum for at least 6 months, but none had past or current hepatic decompensation. Patients with evidence of infection with hepatitis C
Features at the time of diagnosis
The main features at presentation of the 269 patients included in the study are summarized in Table 1.Serum HBV DNA was detected in all of the patients, either at baseline (220 cases) or during follow-up (49 cases, all positive for anti-HBe). HBV genotype was identified in 254 cases (94%): genotype A in 140 (52%), genotype D in 94 (35%), and genotype F in 20 (7%). Other genotypes were not identified, and the PCR/restriction fragment length polymorphism assay was not conclusive in 15 cases (6%).
Discussion
Several circumstances, including environmental, host, and HBV-related factors, have been recognized as important determinants of the highly variable outcome of chronic HBV infection. However, information concerning the possible role of HBV genotype on the natural history of this disease is rather limited. Previous cross-sectional studies provided controversial data,15, 16, 17, 18 and only a longitudinal survey concerning Chinese patients with HBV genotype B or C infection has been reported thus
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Supported in part by a grant from Ministerio de Educación y Cultura (SAF 2000-0048).
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Address requests for reprints to: José M. Sánchez-Tapias, M.D., Liver Unit, Hospital Clinic, Villarroel 170, 08036 Barcelona, Spain. e-mail: [email protected]; fax: (34) 93-451-5522.