Hepatitis B Genotypes Correlate With Clinical Outcomes in Patients With
Chronic Hepatitis B

GASTROENTEROLOGY 2000;118:554-559
JIA-HORNG KAO,* PEI-JER CHEN,* MING-YANG LAI,* and DING-SHINN CHEN,
*Graduate Institute of Clinical Medicine, Hepatitis Research Center, and
Department of Internal Medicine, National Taiwan University College of
Medicine and National Taiwan University Hospital, Taipei, Taiwan

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 genotypes in Taiwan
and the association between distinct genotypes and severity of liver disease
in a cross-sectional study.

Methods:
Using a molecular method, HBV genotypes were determined in 100 asymptomatic
carriers and in 170 patients with histologically verified chronic liver
disease and hepatocellular carcinoma (HCC).

Results:
All genotypes except genotype E were identified in Taiwan, and genotypes B
and C were pre{*filter*}. Genotype C was prevalent 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 significantly more common in patients with HCC
aged less than 50 years compared with age-matched asymptomatic carriers (80%
vs. 52%, P = 0.03). This pre{*filter*} was more marked in younger
patientswith HCC (90% in those aged 35 years), most of whom did not have
cirrhosis.

Conclusions:
Our data suggest that HBV genotype C is associated with more severe liver
disease and genotype B may be associated with the development of HCC in
young Taiwanese. However, additional large-scale longitudinal studies are
needed to confirm the relationship of HBV genotypes to liver disease
severity and clinical outcomes.