Eight genotypes(A-H) of hepatitis B virus(HBV) have been identified.However,the impact of different genotypes on the clinical course of hepatitis B infection remains controversial.We investigated the frequency and cli...Eight genotypes(A-H) of hepatitis B virus(HBV) have been identified.However,the impact of different genotypes on the clinical course of hepatitis B infection remains controversial.We investigated the frequency and clinical outcome of HBV genotypes and genotype mixtures in HBV-infected patients from Vietnam,Europe,and Africa.In addition,we analyzed the effects of genotype mixtures on alterations in in vitro viral replication.In Asian patients,seven genotypes(A-G) were detected,with A,C,and D predominating.In European and African patients,only genotypes A,C,D,and G were identified.Genotype mixtures were more frequently encountered in African than in Asian(P =.01) and European patients(P =.06) .In Asian patients,the predominant genotype mixtures included A/C and C/D,compared to C/D in European and A/D in African patients.Genotype A was more frequent in asymptomatic compared with symptomatic patients(P <.0001) .Genotype C was more frequent in patients with hepatocellular carcinoma(HCC;P =.02) .Genotype mixtures were more frequently encountered in patients with chronic hepatitis in comparison to patients with acute hepatitis B(P =.015) ,liver cirrhosis(P =.013) ,and HCC(P =.002) .Viral loads in patients infected with genotype mixtures were significantly higher in comparison to patients with a single genotype(P =.019) .Genotype mixtures were also associated with increased in vitro HBV replication.In conclusion,infection with mixtures of HBV genotypes is frequent in Asia,Africa,and Europe.Differences in the replication-phenotype of single genotypes compared to genotype-mixtures suggest that co-infection with different HBV-genotypes is associated with altered pathogenesis and clinical outcome.展开更多
文摘Eight genotypes(A-H) of hepatitis B virus(HBV) have been identified.However,the impact of different genotypes on the clinical course of hepatitis B infection remains controversial.We investigated the frequency and clinical outcome of HBV genotypes and genotype mixtures in HBV-infected patients from Vietnam,Europe,and Africa.In addition,we analyzed the effects of genotype mixtures on alterations in in vitro viral replication.In Asian patients,seven genotypes(A-G) were detected,with A,C,and D predominating.In European and African patients,only genotypes A,C,D,and G were identified.Genotype mixtures were more frequently encountered in African than in Asian(P =.01) and European patients(P =.06) .In Asian patients,the predominant genotype mixtures included A/C and C/D,compared to C/D in European and A/D in African patients.Genotype A was more frequent in asymptomatic compared with symptomatic patients(P <.0001) .Genotype C was more frequent in patients with hepatocellular carcinoma(HCC;P =.02) .Genotype mixtures were more frequently encountered in patients with chronic hepatitis in comparison to patients with acute hepatitis B(P =.015) ,liver cirrhosis(P =.013) ,and HCC(P =.002) .Viral loads in patients infected with genotype mixtures were significantly higher in comparison to patients with a single genotype(P =.019) .Genotype mixtures were also associated with increased in vitro HBV replication.In conclusion,infection with mixtures of HBV genotypes is frequent in Asia,Africa,and Europe.Differences in the replication-phenotype of single genotypes compared to genotype-mixtures suggest that co-infection with different HBV-genotypes is associated with altered pathogenesis and clinical outcome.
