AIM： To identify the most common hepatitis B virus （HBV） genob/pe in Saudi Arabia, and correlate the prevailing genob/pes with the clinical outcome of patients. METHODS： Patients were consecutively recruited from ...AIM： To identify the most common hepatitis B virus （HBV） genob/pe in Saudi Arabia, and correlate the prevailing genob/pes with the clinical outcome of patients. METHODS： Patients were consecutively recruited from the hepatology clinics of two tertiary care referral centers. Patients were categorized into 4 different groups： group 1, patients with hepatitis B and normal liver enzymes; group 2, patients with hepatitis B and abnormal liver enzymes but without cirrhosis; group 3, patients with hepatitis B and liver cirrhosis; group 4, patients with hepatitis B and hepatocellular carcinoma. All patients had a positive hepatitis B surface antigen （HBsAg）. Genob/ping of HBV was performed by nested PCR-mediated amplification of the target sequence and hybridization with sequence-specific oligonucleotides. RESULTS： Seventy patients were enrolled in this study. They were predominantly male （72.9%） in their midforty＇s （mean age 47 years）. Forty-nine （70%） patients were hepatitis B envelope antigen （HBeAg） negative. The majority of patients （64%） acquired HBV through unknown risk factors. Hepatitis B genob/ping revealed that 57 patients （81.4%） were genob/pe D, 1 patient （1.4%） had genob/pe A, 1 patient （1.4%） had genotype C, and 4 patients （5.7%） had genob/pe E, while 7 patients （10%） had mixed genob/pe （4 patients ADG, 1 patient DE, 1 patient DF, and 1 patient ADFG）. Based on univariate analysis of genob/pe D patients, significant predictors of advanced liver disease were age, gender, aspartate transaminase, alanine transaminase, albumin,bilirubin, and alkaline phosphatase （all P 〈 0.001）. In multivariate analysis decreased hemoglobin （r = -0.05; 95% CI： -0.08 to -0.03; P = 0.001） and albumin levels （r = -0.004; 95% CI： -0.007 to -0.001; P = 0.002） were highly significant predictors of advanced liver disease. In patients with HBV genotype D, HBeAg negativity was found to increase across advancing stages of liver disease （P = 0.024）. CONCLUSION： This study highlights that the vast majority of Saudi patients with chronic hepatitis B have genotype D. No correlation could be observed between the different genotypes and epidemiological or clinical factors. The relationship between genotype D and HBeAg status in terms of disease severity needs to be further elucidated in larger longitudinal studies.展开更多
基金Supported by a grant from the Research Center at the College ofMedicine, King Saud University, Riyadh
文摘AIM： To identify the most common hepatitis B virus （HBV） genob/pe in Saudi Arabia, and correlate the prevailing genob/pes with the clinical outcome of patients. METHODS： Patients were consecutively recruited from the hepatology clinics of two tertiary care referral centers. Patients were categorized into 4 different groups： group 1, patients with hepatitis B and normal liver enzymes; group 2, patients with hepatitis B and abnormal liver enzymes but without cirrhosis; group 3, patients with hepatitis B and liver cirrhosis; group 4, patients with hepatitis B and hepatocellular carcinoma. All patients had a positive hepatitis B surface antigen （HBsAg）. Genob/ping of HBV was performed by nested PCR-mediated amplification of the target sequence and hybridization with sequence-specific oligonucleotides. RESULTS： Seventy patients were enrolled in this study. They were predominantly male （72.9%） in their midforty＇s （mean age 47 years）. Forty-nine （70%） patients were hepatitis B envelope antigen （HBeAg） negative. The majority of patients （64%） acquired HBV through unknown risk factors. Hepatitis B genob/ping revealed that 57 patients （81.4%） were genob/pe D, 1 patient （1.4%） had genob/pe A, 1 patient （1.4%） had genotype C, and 4 patients （5.7%） had genob/pe E, while 7 patients （10%） had mixed genob/pe （4 patients ADG, 1 patient DE, 1 patient DF, and 1 patient ADFG）. Based on univariate analysis of genob/pe D patients, significant predictors of advanced liver disease were age, gender, aspartate transaminase, alanine transaminase, albumin,bilirubin, and alkaline phosphatase （all P 〈 0.001）. In multivariate analysis decreased hemoglobin （r = -0.05; 95% CI： -0.08 to -0.03; P = 0.001） and albumin levels （r = -0.004; 95% CI： -0.007 to -0.001; P = 0.002） were highly significant predictors of advanced liver disease. In patients with HBV genotype D, HBeAg negativity was found to increase across advancing stages of liver disease （P = 0.024）. CONCLUSION： This study highlights that the vast majority of Saudi patients with chronic hepatitis B have genotype D. No correlation could be observed between the different genotypes and epidemiological or clinical factors. The relationship between genotype D and HBeAg status in terms of disease severity needs to be further elucidated in larger longitudinal studies.
