Characterization of hepatitis B virus genotypes and quantitative hepatitis B surface antigen titres in North American tertiary referral liver centres

Liver Int. 2013 Oct;33(9):1363-9. doi: 10.1111/liv.12222. Epub 2013 Jun 14.


Background & aims: Hepatitis B virus (HBV) genotype and quantitative hepatitis B surface antigen (qHBsAg) have been related to clinical outcome. In this nationwide cross-sectional study, we aimed to investigate the epidemiology and clinical significance of HBV genotype and qHBsAg in patients with chronic hepatitis B (CHB).

Methods: Six hundred and thirty patients with CHB were seen in four urban tertiary referral centres in Canada. HBV genotype was determined by line probe assay (INNO-LIPA) and HBV DNA quantified by commercial PCR (Roche TaqMan, sensitivity <55 IU/ml or AMPLICOR, sensitivity <60 IU/ml). Titres of qHBsAg were determined by an in-house assay based on the WHO standard (calibration range 0.24-62.5 IU/ml).

Results: In 630 patients (57% male, 69% Asian, median age 42 years), 21% were hepatitis B e antigen positive and the median alanine aminotransferase was 29 U/L. The HBV genotype distribution was A (16%), B (29%), C (31%), D (16%), E (6%). HBV genotype was strongly associated with ethnicity, but neither genotype nor qHBsAg correlated with the degree of fibrosis. In the treatment-naïve patients, the baseline qHBsAg levels correlated with HBV DNA (r = 0.2517, P < 0.0008). The median qHBsAg levels were lowest in patients with genotype B (P < 0.0001), but no significant correlation was noted with all other HBV genotypes.

Conclusions: In this large North American HBV epidemiological study, genotypes B and C were the most common; however, all genotypes (A-E) were observed with varied distribution nationwide. Baseline qHBsAg significantly correlated with HBV DNA and with HBV genotype B, but not with liver fibrosis.

Keywords: Canada; HBV DNA; HBV genotype; chronic hepatitis B; quantitative hepatitis B surface antigen.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alanine Transaminase / blood
  • Analysis of Variance
  • Canada / epidemiology
  • Cross-Sectional Studies
  • Female
  • Genotype
  • Hepatitis B / epidemiology*
  • Hepatitis B / pathology
  • Hepatitis B / virology
  • Hepatitis B Surface Antigens / blood*
  • Hepatitis B virus / genetics*
  • Humans
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • Sensitivity and Specificity


  • Hepatitis B Surface Antigens
  • Alanine Transaminase