Influence of hepatitis B virus genotype on the long-term outcome of chronic hepatitis B in western patients

Gastroenterology. 2002 Dec;123(6):1848-56. doi: 10.1053/gast.2002.37041.


Background & aims: The aim of this study was to investigate if the variable outcome of chronic hepatitis B may be related to hepatitis B virus (HBV) genotype.

Methods: The clinical and virologic events observed over prolonged follow-up in 258 Spanish patients with chronic hepatitis B infected with different genotypes of HBV were compared.

Results: The prevalence of genotype A, D, and F was 52%, 35%, and 7%, respectively. Concomitant sustained biochemical remission and clearance of HBV DNA occurred at a higher rate in genotype A- than in genotype D- (log-rank, 14.2; P = 0.002) or genotype F-infected patients (log-rank, 4.2; P = 0.03). The rate of hepatitis B surface antigen (HBsAg) clearance was higher in genotype A than in genotype D hepatitis (log-rank, 4.6; P = 0.03). Sustained remission and clearance of HBsAg were associated with infection with genotype A by Cox regression analysis. Seroconversion to antibody to hepatitis B e antigen (anti-HBe) was unrelated to HBV genotype, but the rate of sustained remission after seroconversion was higher in genotype A than in genotype D hepatitis both in patients who seroconverted to anti-HBe during follow-up (log-rank, 4.5; P = 0.03) and in patients with positive anti-HBe at baseline (log-rank, 6.66; P = 0.009). Death related to liver disease was more frequent in genotype F than in genotype A (P = 0.02) or genotype D (P = 0.002) hepatitis.

Conclusions: The long-term outcome of chronic hepatitis B is different in patients infected with HBV genotype A, D, or F.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • DNA, Viral / blood
  • Female
  • Gene Frequency
  • Genotype
  • Hepatitis B Surface Antigens / analysis
  • Hepatitis B virus / genetics*
  • Hepatitis B, Chronic / drug therapy
  • Hepatitis B, Chronic / genetics
  • Hepatitis B, Chronic / physiopathology
  • Hepatitis B, Chronic / virology*
  • Humans
  • Liver / physiopathology
  • Male
  • Middle Aged
  • Remission Induction
  • Spain
  • Time Factors
  • Treatment Outcome


  • DNA, Viral
  • Hepatitis B Surface Antigens