| Background The genetic variability of HBV is very high. The clinical outcome of infection has significant individual variability, and depends on the HBV genome polymorphism, environmental factors and inheritance identity of the host. However, the impact of natural variability of the virus on the clinical courses has become the focus on research recently. Judging from the current information, the relationship of HBV genotypes and liver diseases has not been clearly. But it has been known that high viral replication is a major risk factor for the development of both liver cirrhosis (LC) and hepatocellular carcinoma, therefore antiviral therapies might be indicated even in the absence of active liver disease to decrease the risk of developing hepatocellular carcinoma. With the in-depth study, we are concerning the relationship among genotypes, the natural spectra and antiviral effects.Objectives In order to investigate the distribution of HBV genotypes in Anhui province and its clinical significance related to natural history, viral loads, HBeAg statue and seroconversion, antiviral effects and YMDD mutation treated by co-IFN, ADV and LMV.Methods HBV DNA, HBV genotypes and YMDD mutation had been examined by Caplier Microchip electrophoresis, and the PCR products were sequenced randomly. HBV serology has been tested by EILISA. Liver biochemical quantitative analysis detected by automatic biochemical analyzer.Results Of the serial samples from 367 HBV DNA positive patients without antiviral therapies, 250(68.2%) were genotype B and 82(22.3%) genotype C, 18(4.9%) genotype BC combination. It is suggested that genotype B and C were preponderant in Anhui province. There was significant deference in the distribution of HBV genotypes (p<0.05), which genotype C was advantaged in north of Huaihe River while genotype B in south of Huaihe River. With the geographical environment changes from north to south, genotype B was increasing gradually but genotype C reducing. The rates of HBeAg positive were higher in genotype C than genotype B(65.9% vs 55.2%), but the value of logarithm HBV DNA, the positive rates of HBeAg and HBeAb were no significant among the detected genotypes(p>0.05). HBV genotypes, clinical spectra and age grades were closely related. Along with the increase in age grades, genotype B and chronic hepatitis B(CHB) declined gradually, while genotype C, genotype BC combination and LC increased (P<0.05). Genotype B was more frequently found in CHB than LC, which reversed to genotype C(P<0.05). The rates of ALT, AST normalization, HBV DNA negative, HBeAg spontaneous clearance and seroconversion were equivalent in HBV genotypes(p>0.05). But the rates of ALT, AST normalization in 67 patients of genotype B were highest of ADV(60.9%,73.9%), whereas lowest of IFN(22.2%,27.8%) in 48 weeks(P<0.05), the same as the rate of negative HBV DNA in 12, 24, 48 weeks. The rates of ALT, AST normalization, HBV DNA negative, HBeAg spontaneous clearance and seroconversion in 27 patients of genotype C were identical among antivirus groups(p>0.05). YMDD mutations were detected in 3 of 39 patients after LMV in 48 weeks, and no significant difference in HBV genotypes.Conclusions Genotype B and C were preponderant in Anhui Province. HBV genotypes, clinical spectra and age grades were closely related. Antiviral effect was no difference in HBV genotypes with the same antiviral therapy. Genotype B has a better response to LMV and ADV than IFN. YMDD mutation after LMV was no significant difference in HBV genotypes.
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