Genotype impact on long-term virological outcome of chronic hepatitis B virus infection

Background: The importance of hepatitis B virus (HBV) genotype on the clinical course of chronic HBV infection is not yet clarified. Objectives: To investigate genotype impact on long- term virological outcome of chronic HBV infection. Study design: HBsAg, HBeAg, ALT and HBV DNA levels were determined after a median of 9.2 years of follow-up of 124 adults with chronic HBV infection, of whom 33 were HBeAg-positive at inclusion. Results: HBV DNA levels decreased significantly in patients carrying genotype A (n = 28), B (n = 21) or D (n = 63), but not in those with genotype C infection (n = 12). Loss of HBeAg was seen in 44% (4/9) of patients with genotype C, as compared with 92% (22/24) with non-C genotypes. Loss of HBsAg was seen in 36% (10/28) patients with genotype A, 5% (1/21) with B, 0% (0/12) with C, and 11% (7/63) with genotype D. Conclusions: HBV DNA levels decreased over time in patients infected with genotypes A, B or D. However, highly active genotype C or D infection often remained highly active, implying a risk for progressive liver damage. (c) 2012 Elsevier B.V. All rights reserved.