Clearance of hepatitis B e antigen in patients with chronic hepatitis B and genotypes A, B, C, D, and F

Gastroenterology. 2007 Nov;133(5):1452-7. doi: 10.1053/j.gastro.2007.08.010. Epub 2007 Aug 2.

Abstract

Background & aims: Persistence of hepatitis B e antigen (HBeAg) in chronic hepatitis B has been associated with increased risk for development of cirrhosis and hepatocellular carcinoma. Five hepatitis B virus genotypes were identified in Alaska Native persons; we analyzed clearance of HBeAg by age and genotype.

Methods: In this prospective cohort study, 1158 Alaska Native persons throughout Alaska were tested serially for HBeAg for a median of 20.5 years and were genotyped. Initial and final HBeAg-positive specimens, time to clearance, age at clearance, and subsequent HBeAg results were analyzed for persons initially HBeAg-positive. Subsequent HBeAg results were analyzed for persons initially negative.

Results: Genotypes A, B, C, D, and F were identified. Genotype C persons initially HBeAg-positive were more likely than those with other genotypes to be positive on initial and final specimens (P < .001 for each) and time to HBeAg clearance was longer (P < .001). Age at which 50% of persons cleared HBeAg was <20 years for those infected with genotypes A, B, D, and F and 47.8 years in genotype C (P < .001). After losing HBeAg, those with genotypes C and F were more likely to revert to the HBeAg-positive state (P < .001).

Conclusions: Genotype may have a strong effect on mode of transmission and outcome. Genotype C may have been responsible for most perinatal transmission, given that seroconversion from HBeAg occurs decades later than in other genotypes.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Alaska
  • Carcinoma, Hepatocellular / genetics
  • Cohort Studies
  • Female
  • Genetic Predisposition to Disease
  • Genotype
  • Hepatitis B e Antigens / blood*
  • Hepatitis B virus / genetics*
  • Hepatitis B virus / immunology*
  • Hepatitis B, Chronic / ethnology
  • Hepatitis B, Chronic / genetics*
  • Hepatitis B, Chronic / immunology*
  • Humans
  • Indians, North American / ethnology
  • Indians, North American / genetics
  • Liver Cirrhosis / genetics
  • Liver Neoplasms / genetics
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors

Substances

  • Hepatitis B e Antigens