Hepatitis B genotypes correlate with clinical outcomes in patients with chronic hepatitis B

Background & Aims: Six genotypes (A-F) of hepatitis B virus (HBV) have been identified; however, the genotype-related differences in the pathogenicity of HBV remain unknown. Therefore, we investigated the prevalence of HBV ge notypes in Taiwan and the association between distinct genotypes and severi ty of liver disease in a cross-sectional study. Methods: Using a molecular method, HBV genotypes were determined in 100 asymptomatic carriers and in 1 70 patients with histologically verified chronic liver disease and hepatoce llular carcinoma (HCC). Results: All genotypes except genotype E were ident ified in Taiwan, and genotypes B and C were predominant. Genotype C was pre valent in patients with cirrhosis and in those with HCC who were older than 50 years compared with age-matched asymptomatic carriers (60% vs. 23%, P < 0.001, and 41% vs. 15%, P = 0.005, respectively). Genotype B was significa ntly more common in patients with HCC aged less than 50 years compared with age-matched asymptomatic carriers (80% vs. 52%, P = 0.03). This predominan ce was more marked in younger patients with HCC (90% in those aged less tha n or equal to 35 years), most of whom did not have cirrhosis. Conclusions: Our data suggest that HBV genotype C is associated with more severe liver d isease and genotype B may be associated with the development of HCC in youn g Taiwanese. However, additional large-scale longitudinal studies are neede d to confirm the relationship of HBV genotypes to liver disease severity an d clinical outcomes.