Abstract
Hepatitis B virus (HBV) infection is a critical global health issue and moderately epidemic in Western China, but HBV molecular epidemiology characteristics are still limited. We conducted this study to investigate HBV genotypes and antiviral resistant mutations in this multi-ethnic area. A total of 1316 HBV patients were recruited from four ethnic groups from 2011 to 2013. Genotypes and resistant mutations were determined by Sanger sequencing. Four genotypes (B, C, D and C/D) were identified. Genotype B and C were common in Han population, while genotype D was predominant in Uygurs. Genotype C was the major genotype in both Tibetans and Yis, and recombinant C/D was found in Tibetans only. Lamivudine resistance was common in all populations, especially in Hans with prevalence of 42.8%. Entecavir resistance was barely observed regardless of ethnicity. Genotype C isolates had higher rates of rtA181T/V than genotype B (13.5% vs. 5.1%, P < 0.001), in accordance with higher prevalence of resistance to adefovir (20.0% vs. 9.5%, P < 0.001). While incidence of resistant mutations to other drugs and clinical factors showed no difference among different genotypes. HBV genotypes and resistance-conferring mutations had different geographic and demographic distributions in Western China, which provided molecular epidemiology data for clinical management.
Highlights
Hepatitis B is one of the major public health priorities with more than 350 million chronic hepatitis B virus (HBV) carriers over the world and causing 686, 000 deaths per year[1,2]
A total of 1316 Hepatitis B virus (HBV) hepatitis B surface antigen (HBsAg) carriers were recruited from five hospitals in four provinces, and HBV reverse transcriptase fragment was amplified successfully from 1221 samples consist of 657 Hans, 472 Tibetans, 46 Uygurs and 46 Yis
We found that the predominant genotypes in Han population were genotype B and C, the distribution frequency varied among different geographic regions
Summary
Hepatitis B is one of the major public health priorities with more than 350 million chronic hepatitis B virus (HBV) carriers over the world and causing 686, 000 deaths per year[1,2]. Combination of rtM204V/I, rtL180M plus one of the following mutations: rtT184S/C/I/A, rtS202G/C/I or rtM250V links to ETV resistance Emergence of such antiviral drug resistant mutations contradicts the benefits of antiviral therapy and even triggers hepatitis flares, liver failure and death for the uncontrollable HBV replication and cascade of liver inflammation. Some other studies showed no statistical difference in response to LMV and LdT among CHB patients with various genotypes[28,29,30]. There are no definite differences in response to nucleos(t) ide analogues between HBV genotypes, our previous study showed that genotype C had a higher incidence of natural antiviral-resistant mutation than genotype B and D, which could lead to poorer response and outcome[31]. Whether HBV genotypes correlated to different drug resistance rates needs to be further investigated
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