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[Relationship between HBV DNA genotype and Chinese medicine syndrome pattern in patients with chronic hepatitis B]
Jun Li1, Hui-Yin Jang, Li-Fu Wang
1Department of Integrative Medicine on Hepatopathy, 302 Hospital of PLA, Beijing. lijun100039@163.com
Insights
Hepatitis B virus (HBV) genotype C is common in China. Patients with blood-stasis obstruction pattern show more severe liver injury and a higher family history of chronic hepatitis B (CHB).
Area of Science:
- Hepatology and Virology
- Traditional Chinese Medicine (TCM)
Context:
- Chronic hepatitis B (CHB) is a significant global health concern.
- Understanding the interplay between viral genotypes and TCM syndrome patterns is crucial for comprehensive patient management.
Purpose:
- To investigate the correlation between hepatitis B virus (HBV) DNA genotypes and Traditional Chinese Medicine (TCM) syndrome patterns in CHB patients.
- To assess the clinical significance of identified correlations, particularly regarding liver injury severity and family history.
Summary:
- A study of 117 CHB patients revealed HBV genotype C as predominant (74.01%).
- The blood-stasis obstruction pattern (V) was associated with more severe liver inflammation (higher HBeAg-negative rate) and a higher prevalence of family CHB history.
- No direct correlation was found between specific HBV genotypes and TCM syndrome patterns.
Impact:
- Highlights the clinical relevance of the blood-stasis obstruction pattern in CHB, indicating potentially more severe disease progression.
- Informs TCM practitioners about the higher likelihood of family transmission in patients presenting with the blood-stasis obstruction pattern.
- Suggests that while HBV genotype may not directly dictate TCM patterns, it coexists within a complex disease presentation.
Objective:
To study the relationship between genotype of HBV DNA and Chinese medicine (CM) syndrome pattern in patients with chronic hepatitis B (CHB).
Methods:
With an open parallel-controlled method adopted, CM syndrome types of 117 CHB patients were differentiated and their genotypes of HBV DNA in peripheral blood were determined to observe the relationship with syndrome pattern and diagnostic degree of hepatitis.
Results:
(1) The HBV DNA genotype distribution in CHB patients was: type B in 17.51% (31 cases) of the 117 patients, type C in 131 (74.01%), type B/C in 11 (6.21%) and type D in 1 (0.56%), while the genotype in 3 cases was unable be determined. The proportion of patients with HBV DNA of type C was obviously higher than that with other types (P < 0.01). (2) Distribution of CM syndrome pattern was: 98 patients (55.37%) were differentiated as Gan-stagnation Pi-deficiency pattern (I), 6 (3.39%) as Gan-Shen yin-deficiency pattern (II), 2 (1.13%) as Pi-Shen yang-deficiency pattern (III), 12 (6.78%) as damp-heat blocking pattern (IV) and 59 (33.33%) as blood-stasis obstruction pattern (V). Sixteen out of the 32 severe CHB patients were differentiated as pattern V, accounting for 50.00%, but showed no statistical difference in comparing with that in patients of other patterns. However, the HBeAg negative rates in patients of pattern V was 62.71% (37/59), significantly higher than that in patients of other patterns (P = 0.00), suggesting that the inflammatory injury of liver was rather severer, and the virus were eliminated partially in the inflammatory reaction. (3) 42.37% (25/59) in patients of pattern V had family history of CHB, the percentage was significantly higher than that in patients of pattern I (P < 0.05).
Conclusions:
HCV DNA of type C is predominant in CHB patients in China. Liver injury in CHB patients of CM syndrome pattern V is severer than that in patients of other patterns. HBV genotype shows no obvious correlativity with CM syndrome pattern of patients, but the cases with family CHB infection history of pattern V take a higher proportion.
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