Both gene mutation detection and hepatitis B virus genotyping might be useful for guiding clinical management of chronic hepatitis B infection in the Area of Tarragona

Identifier:  TFG:113

Handle: https://hdl.handle.net/20.500.11797/TFG113

Authors:  Casacuberta Barberà, Núria

Abstract:
Núria Casacuberta Barberà ABSTRACT BACKGROUND: Despite the availability of an effective vaccine, chronic hepatitis B virus (HBV) infection continues to be a global health concern. In HBV-infected patients, different genotypes, which show a distinct geographical distribution, influence liver disease progression and response to treatment. Therefore, detection of mutations associated to antiviral therapy and HBV-genotyping are essential for monitoring treatment and an accurate diagnosis of chronic hepatitis B (CHB). However, in some populations, such as the area of Tarragona, HBV-genotyping is not included in the clinical management of CHB. HYPOTHESIS: Due to immigration, the prevalence of HBV-mutations has increased. Thus, HBV-genotyping and mutation detection could be included in the clinical management, in order to provide an early diagnosis and an optimized treatment. AIM: To determine the prevalence of HBV infection and CHB with precore (preC) variant and correlate it with the previous results and immigration in the area of Tarragona. MATERIAL AND METHODS: A total of 386 HBsAg-positive patients were included. HBeAg, anti-HBe, ALT, AST and HBV-DNA values were analysed and compared according to age, gender, clinical statuses and immigration in the recent three years. RESULTS: Precore mutants were detected in 5.7% of the HVB-infected patients. Among them, males with a means age of 45.5 ± 15.6 years were predominant (77.3%). The findings revealed significantly higher incidence (p < 0.05) of preC mutants in CHB patients from 2009 to 2013. In addition, there were no significant differences in prevalence of HBV-infected patients. CONCLUSION: The results in this study confirm that the distribution of HVB-genotypes and the prevalence of CHB precore mutants have changed due to immigration in the area of Tarragona the recent three years. Given the potential incidence of preC mutants, we suggest a HBV-genotyping as a necessity to help practicing physicians to identify those at risk of disease progression and determine optimal therapy.