Influência do genótipo do vírus da hepatite B na evolução clínica de pacientes portadores crônicos da infecção

Abstract

Hepatitis B virus (HBV) chronic infection has a heterogeneous distribution around the world. Its clinical presentation depends on factors of the carrier such as the age at which he got infected, immunological status and associated diseases. Viral characteristics like the genotype can also influence. The aim of this study was to evaluate the influence of the HBV genotype in the clinical presentation of the chronic infection. This study was performed at the Clinical Research Center and the Liver Unit of the Federal University of Maranhão, with 119 chronic carriers of HBV with defined genotypes. We identified those followed for at least 12 months for their clinical definition. It was included 101 patients: 68 (68%) with genotype A1, 26 (26%) D4, 4(3%) F2a, 2 (2%) D3 and 1 (1%) D2. For the purpose of comparison, two groups were defined: A (n=68) and D (n=29). In the HBV-D group the presence of HBeAg (28% vs 10% P=0.03) and immune tolerant (21.5% vs 1.5% P=0.006) patients were more frequent when compared to carriers of genotype A. There was no age difference between groups (39±13 vs 42±11 P=0.26). In conclusion, we can suggest that among the carriers of genotype D, especially the subgenotype D4, which corresponds to 90% of this, there might be late seroconversion of HBeAg, favoring a higher risk of virus transmission.