HBV Factors and Clinical Outcomes M Omata Genotypes in China and Japan Miyakawa Y et al. Intervirology 2003 North East AsiaWest Asia North East Asia West Asia B and C D Any Difference Between B and C HBeAg-positive Years Born Infected ALT Natural Course HBV Infection As with Flares Years eAg Seroconversion ALT HBeAg Seroconversion When Induced Naturally? This Timing of Seroconversion Varies Any Differences among Genotypes ? HBV Genotypes & Seroconversion BJ McMahon 1158 Eskimos for 20.5 years GASTROENTEROLOGY 2007 SE Livingston Gastroenterology 2007 in press GenotypeNo. of patients Age at time of HBeAg clearance A3419 B620 C3648 D30518 F12616 Clearance of HBeAg in Alaskan natives Genotype C is Late Seroconverter Relation to Liver Diseases Yang HI, J Natl Cancer Inst 2008 Genotype and HCC Genotype B Genotype C 39/803 (4.9%) 40/358 (11.1%) Age of HCC and Genotypes 20s30s40s50s Orito et al. Hepatology s>60 No. of Pt B C B C n=117 Ages The longer period of eAg-pos/high viral load May Bring more Patietns To HCC Genotype C Interferon Effect and Genotypes e Loss & Seroconversion Percent Wong VW, et al. Hepatology. 2010;51: Yrs Post-Peg IFN Genotype & HBeAg Clearance 13/41 9/66 Interferon Therapy Wai CT, Hepatology 2002 Genotype B Genotype C 32% 14% Buster EH, Gastroenterology Interferon & HBsAg Clearance Follow-up 3 years Proportion of initial responders(%) Genotype C (n=9)Genotype B (n=7) 14% HBsAg negative 0% Response to PEG-IFN in HBeAg positive CHB HBeAg Loss HBsAg Loss 2 1 Janssen, Lancet 2005; 2 Flink, Am J Gastro A n=90 28% 47% 44% 25% B n=23 C n=39 D n=103 Percentage of patients (%) A n=90 3% 9% 2% B n=23 C n=39 D n= % Percentage of patients (%) 1 How About Response To Nucs ? Nuc and Genotype Kobayashi M, J Med Virol >192 Weeks HBV DNA Cleared(%) 84% 76% 47% Genotype C (449) Genotype B (38) How about Human Genotype ? Host Factors IL28B in HBV infection ? In hepatitis C, Strong Association IL28B gene and Response to PEG-IFN + RBV IL28B Genotype Distribution p