Individuals with Hepatitis B Virus Genotype C Experience HBeAg Clearance Later and Less Often

It is well known that hepatitis C virus (HCV) genotype has a major influence on the natural history of disease, and especially on respons e to interferon-based therapy. But the impact of hepatitis B virus (HBV) genotype has been less extensively studied.

Persistence of hepatitis B "e" antigen (HBeAg) in chronic hepatitis B patients has been associated with increased risk of developing liver cirrhosis and hepatocellular carcinoma.

As reported in the November 2007 issue of Gastroenterology, researchers investigated the association between HBV genotype, natural history of HBV disease, and HBeAg clearance. The prospective cohort study included 1158 Alaskan Natives who were tested regularly for the presence of HBeAg over a median of 20.5 years.

Results

• 5 different HBV genotypes were identified in the Alaska Native population: A, B, C, D, and F.

• People with genotype C who were initially HBeAg positive were more likely to still be positive based on the final specimens than individuals with other genotypes (P < 0.001).

• Further, time to HBeAg clearance was longer in patients with HBV genotype C (P < 0.001).

• The age at which 50% of the initially positive individuals had cleared HBeAg was < 20 years for those infected with genotypes A, B, D, and F, but 47.8 years for those with genotype C (P < 0.001).

• After HBeAg loss, individuals with genotypes C and F were more likely to revert to HBeAg positive state (P < 0.001).

Conclusion

In conclusion, the authors wrote, HBV genotype "may have a strong effect on mode of transmission and outcome."

They suggested that, "Genotype C may have been responsible for most perinatal transmission, given that seroconversion from HBeAg occurs decades later than in other genotypes."

Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AK.

12/14/07

Reference
SE Livingston, JP Simonetti, LR Bulkow, and others. Clearance of Hepatitis B e Antigen in Patients With Chronic Hepatitis B and Genotypes A, B, C, D, and F. Gastroenterology 133(5): 1452-1457. November 2007.