Influence on its Genotypes of the treatment for type B hepatitis

Abstract

Type B hepatitis can be classified according to eight different genotypes (A-H). These genotypes are different in terms of worldwide geographical distribution. In Brazil the most frequent genotypes are A, D and F. Some changes in the genetic structure of these genotypes can cause different levels of pathogenesis, being related to lower or higher risk of developing hepatocellular carcinoma or liver cirrhosis. In addition to the above mentioned differences, heterogeneity of hepatitis B genotypes seems to be related to the differences in clinical evolution of the infection and response to antiviral treatment. Some genotypes proved to have a better response to the treatment using interferon or similar nucleotides than others. This review aimed at showing the importance of treatment of type B hepatitis based on its different genotypes. Different articles from the specific medical literature were reviewed and those including genotypes for type B hepatitis and their association with the treatment of this infection were selected. In the reviewed articles genotype-based treatment of hepatitis B showed significant differences. Genotypes A and B seem to have a better response to the antiviral treatment with alpha interferon and/or lamivudine; however, more studies are necessary to confirm this assertion. Nevertheless, using the present data it is already possible to prove a strong connection between genotypes and antiviral response. Therefore, adjusting treatment to genotypes can cause a better therapeutic response from interferon and nucleotides in type B hepatitis therapy.