BACKGROUND/AIMS: The genotype of hepatitis B virus (HBV) has been suggested to correlate with the clinical outcome of HBV infection. We analyzed the distribution of HBV genotypes according to the clinical outcomes of HBV infection in Jeju island. METHODS: A total of 145 HBsAg-positive samples were enrolled. To identify specific patterns of HBV genotypes, we performed restriction fragment length polymorphism (RFLP). In the case that typical restriction pattern of RFLP was not determined, phylogenetic analysis was performed. RESULTS: RFLP analysis was possible in 65 patients. Clinical diagnoses of the 65 patients with chronic liver disease were as follows: HBeAg-positive healthy carrier (HBeAg+, anti-HBe, HBV DNA+, transaminase normal; n=20); Inactive HBsAg carrier (n=12); chronic hepatitis B (n=14); liver cirrhosis (n=9); hepatocellular carcinoma (n=10). Sixty-two patients showed a typical restriction pattern by HinfI. However, 3 patients showed a unique restriction pattern by HinfI, which were not reported in the literature. When phylogenetic analysis was performed to classify the genotype of these 3 patients, they were also genotype C. However, all 65 patients showed typical restriction patterns by Tsp509I, which were reported in genotype C. CONCLUSIONS: All chronic HBV infections are genotype C in Jeju island regardless of clinical outcomes.
Carcinoma, Hepatocellular/virology ; Carrier State/virology ; Genotype ; Hepatitis B virus/*genetics ; Hepatitis B, Chronic/complications/*virology ; Humans ; Liver Cirrhosis/virology ; Liver Neoplasms/virology ; Polymorphism, Restriction Fragment Length

Adult ; Carrier State ; blood ; immunology ; virology ; Female ; Hepatitis B Surface Antigens ; blood ; Humans ; Hypertension, Portal ; blood ; virology

Carrier State ; virology ; Female ; Hepatitis B ; complications ; Humans ; Lymphoma, Large B-Cell, Diffuse ; virology ; Male ; Middle Aged

OBJECTIVEIn order to understand the prevalence of hepatitis B virus (HBV) precore mutants isolated from asymtomatic carriers in Guangxi.

METHODSNested polymerase chain reaction (nPCR) was used for amplification of HBV DNA precore in 77 carrier sera, followed by HBV DNA nPCR products sequencing using direct sequencing.

RESULTS50.7% of 77 carriers was positive for HBV DNA with a prevalence of mutants 22.1% (17/77). HBV DNA positive rate in the southern part of the autonomous region was 55.6% (20/36). Six of them were mutants, counting for 30%. The common mutation in the southern part was seen T-->C at nt1858 while nt1896 stop mutation was discovered in one sample only, which was accompanied by point mutation at nt1837 (A-->G). HBV DNA positive rate in the northern part was 46.3% (19/41) with 11 of them were mutants, counting for 57.9%. The common mutation in that area stopped at nt1896. Among samples with stopped mutation, 4 samples had mutation at nt1846 (A-->T), 2 samples at nt1862 (G-->T). Both mutation at nt1856 (C-->T) and nt1858 (T-->C) could be seen in sample 734.

CONCLUSIONSThe prevalence of HBV precore mutant in asymptomatic carriers in Guangxi was at the average level in China. Further study is needed to determine the difference between the southern and the northern part of the region in the common type of mutation exists.

Base Sequence ; Carrier State ; virology ; DNA, Viral ; chemistry ; Hepatitis B virus ; genetics ; Humans ; Molecular Sequence Data ; Mutation ; Polymerase Chain Reaction

BACKGROUND/AIMS: The long-term virologic and biochemical changes in patients with HBeAg negative HBV infection, especially in Asia, remain unclear. To address this issue, we conducted a 3 year- retrospective, cohort study. METHODS: A total of 157 patients with HBeAg negative HBV infection who were monitored without treatment were reviewed between January 1999 and March 2004. Those patients were followed up every 3 months with liver function tests and serologic tests. All patients were stratified into 3 groups; inactive carrier (IC), viremic carrier (VC) and chronic hepatitis (CH). Serum HBV DNA was measured by a hybridization assay (sensitivity: 1.4 x 10(5) genomes/mL, Digene Diagnostics, Silver Spring, USA). RESULTS: The median age of enrolled patients was 42.7 years (M:F=2.3:1). By single time-point observations, the 3 year-cohort prevalence of HBeAg negative CH varied from 12.7 to 35.8% (median 20.7%) HBeAg negative CH was accumulated over time (P=0.002) and transition rates among three groups after 3 years of follow-up are as follows: IC to CH, 6.0%; IC to VC, 4.1%; VC to CH, 23.2%. VC seems to be a disease state in the middle of transition from IC to CH. CONCLUSIONS: We demonstrated the dynamic changing patterns of HBeAg negative CH with time, of which the change from IC or VC to CH was dominant.
Middle Aged ; Male ; Humans ; Hepatitis B, Chronic/*immunology/virology ; Hepatitis B e Antigens/*blood ; Female ; Carrier State/immunology ; Adult

OBJECTIVETo investigate the distribution of hepatitis B virus genotype in Hubei province (China) and its clinical significance.

METHODSSerum samples from 190 HBV DNA positive patients with chronic HBV infection,including 52 asymptomatic HBV carriers (ASC), 56 chronic hepatitis (CH), 32 fulminant hepatic failure (FHF), 22 liver cirrhosis (LC), and 28 hepatocellular carcinoma (HCC) patients were collected and tested for HBV genotypes by type-specific primers.

RESULTSA simple and precise genotyping system based on PCR using type-specific primers was developed for the determination of genotypes of hepatitis B virus (HBV). Of the 190 patients, 140 (73.7%) were genotype B and 42 (22.1%) were genotype C. Genotype B was more prevalent in the FHF and HCC patients than in the ASC patients; the ALT value was significantly higher in genotype B than in genotype C patients. The rate of anti-HBe was significantly higher in genotype B than in genotype C except in the patients of the ASC group.

CONCLUSIONThe system we used seems to be a useful tool for the molecular diagnosis of HBV infection and for large-scale surveys. Genotype B, genotype C and BC combination exist in Hubei province, and genotype B is the major genotype in this area especially in FHF and HCC patients.

Adult ; Carcinoma, Hepatocellular ; virology ; Carrier State ; virology ; China ; Female ; Genotype ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; complications ; virology ; Humans ; Liver Cirrhosis ; virology ; Liver Failure, Acute ; virology ; Liver Neoplasms ; virology ; Male ; Middle Aged

Adolescent ; Adult ; Carrier State ; virology ; Child ; Enzyme-Linked Immunosorbent Assay ; Female ; Genotype ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; virology ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction

OBJECTIVETo study the correlations between clinical features and liver pathohistological changes of chronic hepatitis B virus (HBV) carriers and to discuss the factors which may influence the prognosis.

METHODSNinety HBV carriers who had liver biopsies were enrolled in this study.

RESULTS(1) The mean follow-up period of the patients was 118 weeks. (2) Fifty-four patients (60.0%) had G1 hepatitis and 21 (23.3%) had G2 hepatitis. The fibrosis stages were graded as S1(42) and S2(21). (3) There were significant age differences among S0, S1 and S2. (4) There were significant differences in aminotransferase levels between patients who had a normal liver histology and those who had mild hepatitis. (5) The grades of liver inflammation were not correlated with the titers of HBeAg and HBV DNA in sera. The stages of liver fibrosis were not correlated with the titers of HBVDNA in sera. Most of the HBeAg negative patients progressed to S2. (6) There were significant differences in spleen dimensions measured by ultrasonography between S0, S1 and S2 patients. (7) During the follow-up period serum aminotransferase (ALT) levels remained normal in 60 patients (group A); 22 patients had transient elevations (group B), and 8 patients had persistent increases (group C). There were significant differences of the ratios of S0 and S2 cases among patients in groups A, B and C. (8) Age and fibrosis stages were predictive factors of liver cirrhosis.

CONCLUSIONSMost chronic HBV carriers had mild inflammatory histological changes in their livers and also had different degrees of liver fibrosis. This follow-up study shows that some of those carriers should have had antiviral therapy.

Adult ; Carrier State ; diagnosis ; pathology ; virology ; Female ; Hepatitis B virus ; Hepatitis B, Chronic ; diagnosis ; pathology ; Humans ; Liver Cirrhosis ; diagnosis ; pathology ; virology ; Male ; Middle Aged ; Prognosis

OBJECTIVEIn China, liver failure is also termed as severe hepatitis in whom chronic severe hepatitis B (CSHB) is most common. The aim of this study was to assess whether CSHB based on different liver injury extent can meet the international definition of acute-on-chronic liver failure(ACLF)criteria, according by their clinical and pathological feature.

METHODSA total of 91 patients with CSHB were involved in the study. The clinical findings, laboratory data and liver pathology features were retrospectively analyzed and grouped by hepatitis virus B carrier state (HBC), chronic hepatitis B (CHB) or liver cirrhosis (LC) before they started liver failure.

RESULTS74 out of the 91 patients were male and 17 were female, the mean age was 40.6+/-11.2 years. 9.9%, 7.7% and 82.4% of the patients were based on HBC, CHB and LC respectively. The ages of HBC group were youngest. The mean age of HBC group (years) (25.8+/-6.6) was significantly lower than that of CHB group (36.9+/-9.0) and LC group (42.0+/-10.5)with P values of 0.032 and 0.001 respectively. Most cases presented with sub-acute liver failure characterized by high icterus and ascites. Predisposing factors included exertion, superinfection, virus variation, drugs or alcoholic injury. No difference found between PTA (F = 0.906, P = 0.408) and TBil (F = 0.839, P = 0.436) among the above three groups. The Alb and CHE levels in LC group were (30.3+/-5.1) g/L and (2926.8+/-1471.1) U/L respectively, which were lower than both HBC group [Alb (35.6+/-5.1) g/L, CHE (4363.5+/-2063.2) U/L] and CHB group [Alb (37.4+/-5.0) g/L, CHE (5167.1+/-1522.1) U/L] (F = 9.450; F = 9.297; P value less than 0.01).The level of CHO (1.8+/-1.0) mmol/L in LC group was lower than that of HBC group (2.9+/-1.0mmol/L, P = 0.034), while serum HBV DNA level of HBC group [(6.8+/-1.7) log10copies/ml] was higher than that of LC group [(4.2+/-2.6) log10copies/ml]. The liver tissue in HBC and CHB group showed massive or submassive necrosis which distribute evenly in different parts of liver and similarly in slides, most like acute/subacute severe hepatitis. The chronic lesion was easily covered by extensive necrosis in CSHB based on CHB, with portal fibrosis can be seen by masson stain. Characteristic picture of LC group were massive or submassive necrosis with some nodules were intact or only patchy necrosis of the parenchyma, disparity of extent and stage of necrosis existed in slides, which were the major difference in histopathological change in HBC and CHB group.

CONCLUSIONMost of CSHB cases were based on liver cirrhosis, which match with the international definition of ACLF, while small part of CSHB cases based on HBC and CHB are identical to acute/subacute liver failure.

Adult ; Carrier State ; pathology ; virology ; Female ; Hepatitis B, Chronic ; pathology ; Humans ; Liver Cirrhosis ; pathology ; virology ; Liver Failure ; etiology ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

OBJECTIVETo understand the prevalence of HBV core promoter mutant (T1762 A1764 mutant) isolated from asymptomatic carriers from areas with higher and lower incidence of hepatocellular carcinoma (HCC) in Guangxi.

METHODSA nested polymerase chain reaction (nPCR) was used for amplification of HBV DNA core promoter in sera, and then HBV DNA nPCR products were sequenced by direct sequencing.

RESULTSThe results show that 50.6% (39/77) of all HBV asymptomatic carriers were positive for HBV DNA HBV DNA positive rates of the samples from HCC higher incidence area, Longan County, and from lower incidence area, Guilin city were 55.6% (20/36) and 46.3% (19/41), respectively. HBV core promoter mutants could be seen in 35% in Longan positive samples and 47.4% in Guilin. The common mutations in both regions were all double mutations (nt 1,762 A-->T; nt 1,764 G-->A), accounting for 25% and 21%, respectively. The difference of the double mutant between Longan County and Guilin city was not significant (P>0.05).

CONCLUSIONSThese data implicated that the prevalence of HBV core promoter mutant isolated from asymptomatic carriers may not be correlated with the incidence of HCC in Guangxi.

Adolescent ; Adult ; Carcinoma, Hepatocellular ; virology ; Carrier State ; virology ; DNA, Viral ; genetics ; Female ; Hepatitis B ; virology ; Hepatitis B Core Antigens ; genetics ; Hepatitis B virus ; genetics ; Humans ; Liver Neoplasms ; virology ; Male ; Middle Aged ; Point Mutation ; Promoter Regions, Genetic ; genetics