HBeAg and not genotypes predicts viral load in patients with hepatitis B in Denmark: A nationwide cohort study

Abstract

Objective. To explore the influence of HBV genotype on viral load in patients with HBV infection, and to investigate the relation to gender, age and country of origin or antibodies against hepatitis Be antigen (anti-HBe). Materials. We investigated 1025 patients with hepatitis B virus infection in a nationwide study in Denmark. Results. Prevalence of genotypes were: 10.5% A, 17.3% B, 20.5% C, 45.7% D, 3.2% E, 0.6% F, 1.1% G and 1% had more than one genotype. Nearly 60% of patients with genotype A were from Africa, 82% and 93% with genotypes B or C were from East Asia, 62% with genotype D came from the Middle East and 91% with genotype E came from Africa. More women had genotypes B (p = 0.006) or C (p < 0.001) while more men had genotypes A (p = 0.015) or D (p < 0.001). Women with genotypes B and D were younger than men (p < 0.001, p = 0.026). Viral load differed in genotype A and D compared with B and C (p < 0.001), and between anti-HBe and hepatitis B e antigen (HBeAg) positive patients (median values 5.4 × 10³ IU/ml and 7.4 × 10⁷ IU/ml, respectively, p < 0.001). Viral load depended on the presence of HBeAg (p < 0.001; OR, 95% CI: 0.05, 0.03–0.07) in the adjusted analysis and was not affected by origin (p = 0.65), age (p = 0.12), gender (p = 0.06) or genotype (p = 0.10). Conclusion. HBeAg status and not HBV genotype influenced viral load in this nationwide study. HBeAg positive patients had median HBV-DNA levels 10,000 times higher than those anti-HBe positive across genotypes.

Key Words::

• anti-HBe
• genotype
• HBV-DNA
• hepatitis B virus

Acknowledgements

The financial support was given by A.P. Møller Foundation for the Advancement of Medical Sciences (grant support to NW).

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.