Does hepatitis B virus (HBV) genotype influence the clinical outcome of HBV infection?

Between 5 and 10% of adults infected with the hepatitis B virus (HBV) devel op a chronic infection lasting longer than 6 months, which may lead to adva nced liver disease. HBV can be classified into six genotypic families: A, B , C, D, E and E but only genotypes A and D are significantly represented in western Europe, where they account for some 90% of cases of infection with HBV, In the present study, we investigated a possible association between HBV genotype A or D and clinical outcome of the infection, We compared the prevalence of these genotypes in a group of patients with chronic active he patitis to that of a group with acute resolving hepatitis. In patients with chronic active hepatitis, genotype A was found in 28 of 35 patients and ge notype D in only four. The remaining three patients were infected with geno type non-A, non-D. In contrast, genotype D was found in 24 of 30 patients w ith acute hepatitis, whilst genotype A was found in only three patients of this group. Three were infected with genotype non-A, non-D. Our results sho w a clear association between genotype A and chronic outcome (Ficher's exac t test: two-sided P-value, P < 0.0001). They suggest that HBV genotypes may play a role in the virus-host relationship. Possible mechanisms for such a role are discussed.