HBV Genotyping And Analysis Of The Natural History Of The Patients With Concurrent Status Of HBV Serological Markers In Chongqing

Objective: Collection of clinical and laboratory data of patients with chronic hepatitis B virus infection in Chongqing region, and all of these patients had concurrent HBsAg and anti-HBs positivity or concurrent HBeAg and anti-HBe positivity. To investigate the distribution of hepatitis B virus genotypes , and to analyze the clinical features and the natural history of chronic HBV infection.Methods: Clinical information,laboratory data(HBsAg, anti-HBs , HBeAg , anti-HBe, anti-HBc, HBV-DNA, ALT, AST) and sera were collected from 48 patients with chronic hepatitis B virus infection, all of these patients had concurrent HBsAg and anti-HBs positivity or concurrent HBeAg and anti-HBe positivity. HBV genotypes were determined by Nested PCR. Analyses of clinical features between patients with HBsAg+/anti-HBs+ and patients with HBeAg+/anti-HBe+ were performed. Preliminary analyses of the natural history of chronic hepatitis B patients were done according to the features of the four dynamic phases (the immune tolerance group, the immune clearance group, the low replication group and the reactivation group).Results: Of the 48 patients with chronic hepatitis B virus infection, 36 patients had concurrent HBsAg and anti-HBs positivity, 12 patients had concurrent HBeAg and anti-HBe positivity. Age in HBeAg+/anti-HBe+ group was younger (P<0.05). The differences of sex ratio, ALT,AST and HBV-DNA between two groups were not significant (P>0.05). HBV genotypes were determined by nested PCR. Of 36 cases with HBsAg+/anti-HBs+, 3(8.3%)cases were subgenotypes B2, 12(33.3%)cases were subgenotypes C2, and genotypes of other 21(58.4%)cases were not detected. Of 12 cases with HBeAg+/anti-HBe+, 8(66.7%)cases were subgenotypes B2, 1(8.3%)case was subgenotype C2 and genotypes of other 3(25.0%)cases were not detected. In 48 concurrent patients, 14(29.2%) patients with the coexistence of HBsAg and anti-HBs were in low-replication phase and 7(14.6%) patients were in reactivation phase. 5 (10.4%) patients with the coexistence of HBeAg and anti-HBe, or 2 (4.2%)patients with the coexistence of HBsAg and anti-HBs were in immune clearance phase.Conclusion: In Chongqing, the main genotypes of hepatitis B virus in patients with chronic hepatitis B virus infection(HBsAg+/anti-HBs+ or HBeAg+/anti-HBe+) were genotype B and C, subgenotypes of genotype B were B2, subgenotypes of genotype C were C2. Subgenotypes B2 were prevalent in hepatitis B patients with concurrent HBeAg and anti-HBe positivity, while subgenotypes C2 were predominant in hepatitis B patients with concurrent HBsAg and anti-HBs positivity, followed by B2 subgenotypes.