HBV genotyping of 702 hepatitis B patients in Changchun,China and its clinical significance

Objective To investigate the distribution of HBV genotypes in Changchun,China,as well as the association of genotypes with virus replication level,serum markers,and liver impairment and its clinical significance. Methods A total of 702 patients with HBV infection who visited The First Hospital of Jilin University from August 2013 to May 2016 were enrolled. Real- time PCR was used to determine HBV genotypes. HBV DNA load,serum markers,and liver function were measured,and the association between genotype and clinical test items was analyzed. The independent samples t- test was used for the comparison of means between groups,and the chi- square test was used for comparison of categorical data between groups. The Mann- Whitney U test was used to investigate the distribution of HBV genotypes in different diseases. Results Of all patients with HBV infection,664 underwent successful genotyping,among whom 484( 72. 9%) had genotype C,168( 25. 3%) had genotype B,and 12( 1. 8%) had genotype B + C. There were no differences in the distribution of HBV genotypes between patients with different sexes or ages. Compared with those with genotype B HBV infection,the patients with genotype C HBV infection had significantly higher HBV DNA load( 6. 68 ± 1. 20 log10 copies / ml vs 5. 15 ± 1. 37 log10 copies / ml,t = 13. 714,P < 0. 001) and HBsAg( +) + HBeAg( +) + anti- HBc( +)( χ2= 21. 687,P < 0. 001). There was no significant difference in HBsAg( +) + anti- HBe( +) + anti- HBc( +)between the two groups( χ2= 2. 124,P = 0. 145). The patients with genotype B had significantly higher levels of HBsAg and anti- HBe than those with genotype C( χ2= 28. 780,P < 0. 001). Compared with those with genotype B,the patients with genotype C had significantly higher levels of alanine aminotransferase( ALT) and aspartate aminotransferase( AST)( ALT: 307. 6 ± 113. 4 U / L vs 285. 8 ± 96. 2 U / L,t = 2. 229,P = 0. 026; AST: 211. 1 ± 96. 4 U / L vs 192. 7 ± 89. 2 U / L,t = 2. 172,P = 0. 030),as well as a significantly lower level of albumin( 37. 6 ± 9. 1 g/L vs 39. 9 ± 10. 6 g/L,t = 2. 701,P = 0. 007). Among the patients with genotype C HBV infection,264 progressed to chronic hepatitis,202 to liver cirrhosis,and 18 to liver cancer; among the patients with genotype B HBV infection,142 progressed to chronic hepatitis,20 to liver cirrhosis,and 6 to liver cancer. The patients with genotype C HBV infection had significantly greater liver injury compared with those with genotype B HBV infection( U = 28 894. 000,P < 0. 001). Conclusion Most of the patients with HBV infection in Changchun have genotype C,followed by genotype B. HBV genotype is not associated with sex or age. The patients with genotype C HBV infection have active HBV DNA replication and show greater association with the severity of liver injury compared with those with genotype B HBV infection.