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Detection of Low Copy Number Integrated Viral DNA Formed by In Vitro Hepatitis B Infection
Published on: November 7, 2018
Comparative study of genotype B and C hepatitis B virus-induced chronic hepatitis in relation to the basic core
Koji Watanabe1, Toru Takahashi, Sumio Takahashi
1Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
Insights
Hepatitis B virus (HBV) genotypes B and C show distinct clinicopathological profiles in Japan. Genotype B is associated with older patients and earlier HBeAg seroconversion, while genotype C exhibits more severe liver inflammation.
Area of Science:
- Hepatology
- Virology
- Genetics
Background:
- Chronic hepatitis B (CHB) outcomes vary by hepatitis B virus (HBV) genotype.
- Genotypes B and C are prevalent in Japan.
- Basic core promoter and precore mutations influence CHB disease activity, but their relation to HBV genotypes is unclear.
Purpose of the Study:
- To investigate the clinicopathological differences between HBV genotypes B and C in Japanese patients.
- To correlate HBV genotypes with basic core promoter, precore mutations, and disease activity.
Main Methods:
- Determined HBV genotypes in 90 CHB patients using ELISA.
- Correlated genotype data with clinicopathological parameters, basic core promoter, precore, and nucleotide 1858 mutations.
Main Results:
- Genotype C (77.8%) was more prevalent than genotype B (22.2%).
- Genotype B patients were older, showed earlier HBeAg to anti-HBe seroconversion, and had different histological activity index scores compared to genotype C.
- The double mutation (1762T/1764A) was more frequent in genotype C, while the precore mutation (1896A) was more common in genotype B.
Conclusions:
- HBV genotype B and C exhibit distinct clinical and pathological features.
- These genotypic differences are linked to specific mutations in the basic core promoter and precore regions.
Background:
The clinicopathological profiles and outcome of chronic hepatitis B can differ by hepatitis B virus (HBV) genotypes. In Japan, genotype B and C are two major HBV genotypes. The basic core promoter and precore mutations are other known viral factors for disease activity, although the relationship between HBV genotypes and these mutations is not fully understood.
Methods:
The HBV genotypes in 90 patients with chronic hepatitis B were determined using an ELISA. Obtained data were correlated with clinicopathological parameters, basic core promoter, precore and the nucleotide 1858 mutations of the HBV genome.
Results:
Among 90 cases, 20 (22.2%) had genotype B and 70 (77.8%) had genotype C HBV. Genotype B patients were older than genotype C patients (44.0 +/- 13.9 vs 34.7 +/- 11.0 P = 0.0022). The HBeAg was more prevalent in genotype C than B patients (P = 0.0008) while anti-HBe was more common in genotype B than C patients (P = 0.0002). Serum aspartate aspartate aminotransferase/alanine aminotransferase levels (B: 220.7 +/- 612.8/257.0 +/- 498.0 IU/L vs C: 111.3 +/- 122.8/201.6 +/- 229.4 IU/L, P = 0.16/0.48) and HBV viral loads in blood (B: 6.1 +/- 3.1 log genome equivalent [LGE]/mL vs C: 6.7 +/- 2.3 LGE/mL, P = 0.42) were equivalent. The seroconversion from HBeAg to anti-HBe occurred significantly earlier in genotype B than C patients (62 +/- 53 months vs 136 +/- 54 months, P = 0.0028) during the mean observation period of 149 +/- 82 months even under various therapeutic modalities. The categories III and IV of the histological activity index in genotype C were higher (III: P < 0.005, IV: P < 0.05, n = 68) than that in B patients whereas category II was higher in genotype B than C patients (P < 0.05). The double mutation (1762T/1764A) in the basic core promoter was more frequently found in genotype C than in B HBV (P = 0.0068), whereas the precore mutation (1896A) was more common in genotype B than C HBV (P = 0.0233). The incidence of 1858C that was complementary to the precore mutation site in the stem-loop structure in, was equally rare in both genotype B and C HBV.
Conclusions:
Genotype B patients were older, had earlier HBeAg seroconversion and exhibited more severe lobular necroinflammation, less portal inflammation and fibrosis than genotype C patients. This genotypic difference is related to the basic core promoter and precore mutations irrespective of 1858C. (c) 2004 Blackwell Publishing Asia Pty Ltd.
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