World-wide epidemiology of HBeAg-negative chronic hepatitis B and associated precore and core promoter variants

Area of Science:

• Hepatology
• Virology
• Epidemiology

Background:

• Hepatitis B is a prevalent global disease.
• Chronic hepatitis B (CHB) patients are often infected with hepatitis B virus (HBV) variants that reduce or eliminate hepatitis B e-antigen (HBeAg) production.
• HBeAg-negative CHB (e-CHB) represents a significant clinical challenge.

Purpose of the Study:

• To conduct a literature review describing the worldwide epidemiology of HBeAg-negative CHB (e-CHB).
• To analyze the prevalence of e-CHB and its associated HBV variants (precore and core promoter) across different geographical regions.

Main Methods:

• A comprehensive literature search was performed to identify relevant studies on e-CHB and HBV variants.
• Fifty studies were included in the analysis.
• Prevalence data for e-CHB and specific HBV variants were extracted and analyzed by geographical region.

Main Results:

• The median prevalence of e-CHB among chronic HBV-infected patients was 33% in the Mediterranean, 15% in the Asia Pacific, and 14% in the USA and Northern Europe.
• The precore stop codon variant was found in a median of 60% of HBeAg-negative patients globally, with higher rates in the Mediterranean (92%) compared to Asia Pacific (50%) and USA/Northern Europe (24%).
• Data on core promoter variants were limited outside Asia, where their median prevalence was 77% among HBeAg-negative patients.

Conclusions:

• HBeAg-negative CHB is more prevalent globally than previously recognized.
• Significant geographical variations exist in the prevalence of e-CHB and its associated HBV variants.
• Further research with standardized assays and population-based samples is needed to accurately estimate e-CHB prevalence and variant distribution.