Kiyoaki Ito1,2, Hiroshi Yotsuyanagi3, Masaya Sugiyama1, Hiroshi Yatsuhashi4, Yoshiyasu Karino5, Yasuhiro Takikawa6, Takafumi Saito7, Yasuji Arase8, Fumio Imazeki9, Masayuki Kurosaki10, Takeji Umemura11, Takafumi Ichida12, Hidenori Toyoda13, Masashi Yoneda2, Yasuhito Tanaka14, Eiji Mita15, Kazuhide Yamamoto16, Kojiro Michitaka17, Tatsuji Maeshiro18, Junko Tanuma19, Masaaki Korenaga1, Kazumoto Murata1, Naohiko Masaki1, Kazuhiko Koike3, Masashi Mizokami1. 1. The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Ichikawa. 2. Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute. 3. Department of Internal Medicine, Graduate School of Medicine, The University of Tokyo. 4. Clinical Research Center, NHO Nagasaki Medical Center, Nagasaki. 5. Department of Gastroenterology, Sapporo Kosei General Hospital, Sapporo. 6. Division of Hepatology, Department of Internal Medicine, Iwate Medical University, Morioka. 7. Department of Gastroenterology, Yamagata University School, Yamagata. 8. Department of Hepatology, Toranomon Hospital. 9. Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba. 10. Division of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo. 11. Department of Medicine, Shinshu University School of Medicine, Matsumoto. 12. Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Shizuoka. 13. Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki. 14. Nagoya City University Graduate School of Medical Sciences, Nagoya. 15. National Hospital Organization Osaka National Hospital, Osaka. 16. Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Okayama. 17. Department of Gastroenterology, Ehime University Graduate School of Medicine, Toon. 18. First Department of Internal Medicine, University Hospital, Faculty of Medicine, University of the Ryukyu, Okinawa, Japan. 19. AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo.
Abstract
BACKGROUND AND AIMS: The prevalence of sexually transmitted acute infections of the genotype A hepatitis B virus (HBV) has been increasing in Japan. Genotype A HBV is associated with an increased risk of HBV progression to chronic infection after acute hepatitis B (AHB) in adults. A nationwide survey was conducted to evaluate the geographic distribution, clinical, and virologic characteristics of genotype A AHB and chronic hepatitis B (CHB) in Japan. METHODS: Five hundred seventy AHB patients were recruited between 2005 and 2010, and 3682 CHB patients were recruited between 2010 and 2011. HBV genotypes were determined for 552 and 3619 AHB and CHB patients, respectively. Clinical characteristics were compared among different genotypes in AHB and CHB patients. Genomic characteristics of HBV genotype A were examined by molecular evolutionary analysis. RESULTS: Hepatitis B virus genotype A was the predominant genotype for AHB between 2005 and 2010. Phylogenetic analysis showed that all strains in the AHB patients with genotype A were classified into subtype Ae. Among CHB patients, the occurrence of genotype A was 4.1%, and genotype A was spreading in young adults. In genotype A CHB patients, early stage liver diseases were predominant, although liver diseases progressed to cirrhosis or hepatocellular carcinoma in some patients. CONCLUSIONS: The distribution of HBV genotypes is quite different between AHB and CHB in Japanese patients. Genotype A infection is spreading in young adults of Japanese CHB patients. Sequences derived from Japanese AHB patients were identical to or closely resembled the sequences derived from other Japanese AHB patients.
BACKGROUND AND AIMS: The prevalence of sexually transmitted acute infections of the genotype A hepatitis B virus (HBV) has been increasing in Japan. Genotype A HBV is associated with an increased risk of HBV progression to chronic infection after acute hepatitis B (AHB) in adults. A nationwide survey was conducted to evaluate the geographic distribution, clinical, and virologic characteristics of genotype A AHB and chronic hepatitis B (CHB) in Japan. METHODS: Five hundred seventy AHB patients were recruited between 2005 and 2010, and 3682 CHB patients were recruited between 2010 and 2011. HBV genotypes were determined for 552 and 3619 AHB and CHB patients, respectively. Clinical characteristics were compared among different genotypes in AHB and CHB patients. Genomic characteristics of HBV genotype A were examined by molecular evolutionary analysis. RESULTS:Hepatitis B virus genotype A was the predominant genotype for AHB between 2005 and 2010. Phylogenetic analysis showed that all strains in the AHB patients with genotype A were classified into subtype Ae. Among CHB patients, the occurrence of genotype A was 4.1%, and genotype A was spreading in young adults. In genotype A CHB patients, early stage liver diseases were predominant, although liver diseases progressed to cirrhosis or hepatocellular carcinoma in some patients. CONCLUSIONS: The distribution of HBV genotypes is quite different between AHB and CHB in Japanese patients. Genotype A infection is spreading in young adults of Japanese CHB patients. Sequences derived from Japanese AHB patients were identical to or closely resembled the sequences derived from other Japanese AHB patients.