Clinical-liver, pancreas, and biliary tractHepatitis B virus genotypes in the United States: results of a nationwide study☆
Section snippets
Patients
This is a cross-sectional study of adults with chronic HBV infection in the United States. Consecutive chronic HBV-infected patients seen in 17 U.S. liver centers during a 1-year period from February 2001 to January 2002 were enrolled. The 17 participating centers were distributed across the United States. These centers can be grouped into 4 regions: East (Mount Sinai School of Medicine, Columbia University, Virginia Commonwealth University, University of Virginia, and Inova Fairfax Hospital),
Results
A total of 694 patients were enrolled. HBV DNA was detected in 530 patients (76%): 196 of 199 (98%) HBeAg-positive and 334 of 495 (68%) HBeAg-negative patients. The mean age of these 530 patients was 43 ± 1 years (range, 13–80 years), and 68% were men. A total of 32% were non-Hispanic white, 9% black, 56% Asian, and 3% of other races. The demographics of these 530 patients were similar to the 164 patients who had undetectable serum HBV DNA using polymerase chain reaction assay. The only
Discussion
In this nationwide study, all 7 HBV genotypes were found in the United States. Genotypes A and C were the most common, followed by genotypes B and D. Contrary to previous small-scale studies,32, 33 genotype A was present in only 35% of the patients studied whereas PC and CP variants were detected in 27% and 44% of the patients, respectively. Several factors may account for the discrepancies between our results and that of earlier studies. First, our study included a larger number of patients
Acknowledgements
The authors thank Innogenetics for providing Inno-Lipa kits for HBV genotyping and detection of precore stop codon and core promoter variants as well as the investigators and study coordinators at the participating centers for their assistance in data and sample collection: Cleveland Clinic: William Carey and Marcia Grealis; Columbia-Presbyterian Medical Center: Robert Brown, Jr., Michelle Lai, and Anna Lang; Indiana University: Paul Kwo; Inova Fairfax Hospital: Zobair Younossi, Terri Martin,
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Supported by the Liver Research Fund (to A.S.F.L.) and in part by National Institutes of Health contract N01-DK-9-2323 and grants U01-DK-60344 and U01-DK-57577 (to A.S.F.L.); Taipei Veterans General Hospital and Research Foundation of Digestive Medicine, Republic of China (to C.J.C.); the Hutchison Program in Translational Medicine at Stanford University (to E.B.K.); and an unrestricted grant from GlaxoSmithKline.