Citation Information :
Raihan R, Akbar SM. A Narrative Review on the Specific Pattern of HBV Genotype in Bangladesh: Clinical Implications for Management. Euroasian J Hepatogastroenterol 2023; 13 (2):152-158.
Background and aims: Bangladesh's unique epidemiological landscape presents an intriguing puzzle. This South Asian nation, with its complex sociodemographic and environmental factors, is home to a diverse array of hepatitis-B virus (HBV) genotypes, identified as Genotype C, with Genotypes D and A also making a significant contribution to the viral landscape. Reviewing such insights is necessary not only to underscore the country's regional diversity in HBV strains but also to bring into focus the clinical implications these genetic variations may have on disease progression and management.
Methods: A thorough database search covered various sources using relevant keywords like “Hepatitis B virus genotypes”, “HBV genotypes in Bangladesh”, and “HBV clinical implications”. The review synthesized findings and analyzed HBV genotype prevalence and clinical implications in Bangladesh.
Results: Genotypes C and D collectively represent 82% of chronic hepatitis-B infection (CHB) cases in Bangladesh, underscoring their regional prevalence. The geographic context is pivotal in understanding HBV infection dynamics and disease progression in this area. Notably, genotype C and the presence of A1762T/G1764A mutations appear to have a distinct impact on disease development, potentially affecting the immune response in CHB patients. This highlights the need for tailored management approaches in this specific region. Further research is vital to confirm and elaborate on these findings, particularly in relation to how these mutations influence the host's immune response.
Conclusion and clinical significance: In summary, studies on HBV genotypes in Bangladesh stress the need for genotype-specific clinical considerations and more research to improve diagnostics and therapies.
World Health Organization. Hepatitis B. Updated on 24 June 2022. Available online: https://www.who.int/news-room/fact-sheets/detail/hepatitis-b (accessed on 30 October, 2023).
Banik S, Datta A, Ghosh A, et al. The prevalence of hepatitis B virus infection in Bangladesh: A systematic review and meta-analysis. Epidemiol Infect 2022;150:e47. DOI: 10.1017/S0950268822000061.
Raihan R, Akbar SMF, Al Mahtab M, et al. Genomic analysis of Hepatitis B virus and its association with disease manifestations in Bangladesh. PLoS One 2019;28;14(6):e0218744. DOI: 10.1371/journal.pone.0218744.
Yan YP, Su HX, Ji ZH, et al. Epidemiology of hepatitis B virus infection in China: Current status and challenges. J Clin Transl Hepatol 2014;2(1):15–22. DOI: 10.14218/JCTH.2013.00030.
Dashtseren B, Bungert A, Bat-Ulzii P, et al. Endemic prevalence of hepatitis B and C in Mongolia: A nationwide survey amongst Mongolian adults. J Viral Hepat 2017;24(9)759–767. DOI: 10.1111/jvh.12697.
Bhaumik P. Epidemiology of viral hepatitis and liver diseases in India. Euroasian J Hepatogastroenterol 2015;5(1):34–36. DOI: 10.5005/iD-iournals-10018-1126.
Persing DH, Varmus HE, Ganem D. The preS1 protein of hepatitis B virus is acylated at its amino terminus with myristic acid. J Virol 1987;61(5):1672–1677. DOI: 10.1128/jvi.61.5.1672-1677.1987.
Liang TJ. Hepatitis B: The virus and disease. Hepatology 2009;49(5): 13–21. DOI: 10.1002/hep.22881.
Lin CL, Kao JH. Natural history of acute and chronic hepatitis B: The role of HBV genotypes and mutants. Best Pract Res Clin Gastroenterol 2017;31(3):249–255. DOI: 10.1016/j.bpg.2017.04.010.
Sunbul M. Hepatitis B virus genotypes: Global distribution and clinical importance. World J Gastroenterol 2014;20(18):5427–5434. DOI: 10.3748/wjg.v20.i18.5427.
Kao JH, Chen PJ, Lai MY, et al. Hepatitis B genotypes correlate with clinical outcomes in patients with chronic hepatitis B. Gastroenterology 2000;118(3):554–559. DOI: 10.1016/s0016-5085(00)70261-7.
Tseng TC, Liu CJ, Yang HC, et al. Higher proportion of viral basal core promoter mutant increases the risk of liver cirrhosis in hepatitis B carriers. Gut 2015;64(2):292–302. DOI: 10.1136/gutjnl-2014-306977.
Yu MW, Yeh SH, Chen PJ, et al. Hepatitis B virus genotype and DNA level and hepatocellular carcinoma: A prospective study in men. J Natl Cancer Inst 2005;97(4):265–272. DOI: 10.1093/jnci/dji043.
Tseng TC, Liu CJ, Yang HC, et al. High levels of hepatitis B surface antigen increase risk of hepatocellular carcinoma in patients with low HBV load. Gastroenterology 2012;142(5):1140–1149.e3; quiz e13-4. DOI: 10.1053/j.gastro.2012.02.007.
Ni YH, Chang MH, Wang KJ, et al. Clinical relevance of hepatitis B virus genotype in children with chronic infection and hepatocellular carcinoma. Gastroenterology 2004;127(6):1733–1738. DOI: 10.1053/j.gastro.2004.09.048.
Livingston SE, Simonetti JP, Bulkow LR, et al. Clearance of hepatitis B e antigen in patients with chronic hepatitis B and genotypes A, B, C, D, and F. Gastroenterology 2007;133(5):1452–1457. DOI: 10.1053/j.gastro.2007.08.010.
Thakur V, Guptan RC, Kazim SN, et al. Profile, spectrum and significance of HBV genotypes in chronic liver disease patients in the Indian subcontinent. J Gastroenterol Hepatol 2002;17(2):165–170. DOI: 10.1046/j.1440-1746.2002.02605.x.
Pezzano SC, Torres C, Fainboim HA, et al. Hepatitis B virus in Buenos Aires, Argentina: Genotypes, virological characteristics and clinical outcomes. Clin Microbiol Infect 2011;17(2):223–231. DOI: 10.1111/j.1469-0691.2010.03283.x.
Roman S, Panduro A, Aguilar-Gutierrez Y, et al. A low steady HBsAg seroprevalence is associated with a low incidence of HBV-related liver cirrhosis and hepatocellular carcinoma in Mexico: A systematic review. Hepatol Int 2009;3(2):343–355. DOI: 10.1007/s12072-008-9115-9.
Roman S, Tanaka Y, Khan A, et al. Occult hepatitis B in the genotype H-infected Nahuas and Huichol native Mexican population. J Med Virol 2010;82(9):1527–1536. DOI: 10.1002/jmv.21846.
Hunt CM, McGill JM, Allen MI, et al. Clinical relevance of hepatitis B viral mutations. Hepatology 2000;31(5):1037–1044. DOI: 10.1053/he.2000.6709.
Mansourian PG, Ghany MG, Thomas E. Spontaneous mutations in the HBV genome and their clinical implications. Curr Hepatitis Rep 2013;12(2):79–87. DOI: 10.1007/s11901-013-0170-x.
Liu CJ, Jeng YM, Chen CL, et al. Hepatitis B virus basal core promoter mutation and DNA load correlate with expression of hepatitis B core antigen in patients with chronic hepatitis B. J Infect Dis 2009;199(5):742–749. DOI: 10.1086/596655.
Sharma S, Sharma B, Singla B, et al. Clinical significance of genotypes and precore/basal core promoter mutations in HBV related chronic liver disease patients in North India. Dig Dis Sci 2010;55(3):794–802. DOI: 10.1007/s10620-009-1083-y.
Kao JH, Chen PJ, Lai MY, et al. Hepatitis B virus genotypes and spontaneous hepatitis B e antigen seroconversion in Taiwanese hepatitis B carriers. J Med Virol 2004;72(3):363–369. DOI: 10.1002/jmv.10534.
Yeh C-T, So M, Ng J, et al. Hepatitis B virus-DNA level and basal core promoter A1762T/G1764A mutation in liver tissue independently predict postoperative survival in hepatocellular carcinoma. Hepatology 2010;52(6):1922–1933. DOI: 10.1002/hep.23898.
Takahashi K, Aoyama K, Ohno N, et al. The precore/core promoter mutant (T1762A1764) of hepatitis B virus: Clinical significance and an easy method for detection. J Gen Virol 1995;76(Pt 12):3159–3164. DOI: 10.1099/0022-1317-76-12-3159.
Ahmad Q, Chowdhury SG, Islam MN, et al. HBsAg amongst unscreened operated patients. Bangladesh Med Res Counc Bull 1991;17(1):11–16. PMID: 1953592.
Mahtab MA, Kumar S, Rahman S, et al. Hepatitis B virus genotypes among chronically infected patients in a tertiary-care hospital in Bangladesh. Indian J Gastroenterol 2006;25(4):219–221. PMID: 16974050.
Ashraf H, Alam NH, Rothermundt C, et al. Prevalence and risk factors of hepatitis B and C virus infections in an impoverished urban community in Dhaka, Bangladesh BMC Infect Dis 2010;10:208. DOI:10.1186/1471-2334-10-208.
Afroz H, Hossain MM, Fakruddin M, et al. A retrospective study on seroprevalence of hepatitis B virus surface antigen (HBsAg) among healthy individuals attending a tertiary clinic in Dhaka, Bangladesh. Int J Biomed Res 2013;4:245–250.
Uz-Zaman MH, Rahman A, Yasmin M. Epidemiology of hepatitis B virus infection in Bangladesh: Prevalence among general population, risk groups and genotype distribution. Genes (Basel) 2018;9(11). DOI: 10.3390/genes9110541.
Paul RC, Rahman M, Wiesen E, et al. Hepatitis B surface antigen seroprevalence among prevaccine and vaccine era children in Bangladesh. Am J Trop Med Hyg 2018;99(3):764–771. DOI: 10.4269/ajtmh.17-0721.
Shaha M, Hoque SA, Rahman SR. Molecular epidemiology of hepatitis B virus isolated from Bangladesh. Springerplus 2016;5(1):1513. DOI: 10.1186/s40064-016-3174-5.
Munshi SU, Tran TTT, Vo TNT, et al. Molecular characterization of hepatitis B virus in Bangladesh reveals a highly recombinant population. PLoS One 2017;12(12):e0188944. DOI: 10.1371/journal.pone.0188944.
Rahman MA, Hakim F, Ahmed M, et al. Prevalence of genotypes and subtypes of hepatitis B viruses in Bangladeshi population. Springerplus 2016;5:278. DOI: 10.1186/s40064-016-1840-2.
Datta S, Banerjee A, Chandra PK, et al. Genotype, phylogenetic analysis, and transmission pattern of occult hepatitis B virus (HBV) infection in families of asymptomatic HBsAg carriers. J Med Virol 2006;78(1):53–59. DOI: 10.1002/jmv.20503.
Block TM, Guo H, Guo JT. Molecular virology of hepatitis B virus for clinicians. Clin Liver Dis 2007;11(4):685–706, vii. DOI: 10.1016/j.cld.2007.08.002.
Yang HI, Yeh SH, Chen PJ, et al. Associations between hepatitis B virus genotype and mutants and the risk of hepatocellular carcinoma. J Natl Cancer Inst 2008;100(16):1134–1143. DOI: 10.1093/jnci/djn243.
Wu JF, Chang MH. Natural history of chronic hepatitis B virus infection from infancy to adult life – The mechanism of inflammation triggering and long-term impacts. J Biomed Sci 2015;22:92. DOI: 10.1186/s12929-015-0199-y.
Chuon C, Takahashi K, Matsuo J, et al. High possibility of hepatocarcinogenesis in HBV genotype C1 infected Cambodians is indicated by 340 HBV C1 full-genomes analysis from GenBank. Sci Rep 2019;9(1):12186. DOI: 10.1038/s41598-019-48304-z.
Sumi H, Yokosuka O, Seki N, et al. Influence of hepatitis B virus genotypes on the progression of chronic type B liver disease. Hepatology 2003;37(1):19–26. DOI: 10.1053/jhep.2003.50036.
Chan HL, Hui AY, Wong ML, et al. Genotype C hepatitis B virus infection is associated with an increased risk of hepatocellular carcinoma. Gut 2004;53(10):1494–1498. DOI: 10.1136/gut.2003.033324.
Fang ZL, Sabin CA, Dong BQ, et al. HBV A1762T, G1764A mutations are a valuable biomarker for identifying a subset of male HBsAg carriers at extremely high risk of hepatocellular carcinoma: A prospective study. Am J Gastroenterol 2008;103(9):2254–2262. DOI: 10.1111/j.1572-0241.2008.01974.
Yang Z, Zhuang L, Lu Y, et al. Naturally occurring basal core promoter A1762T/G1764A dual mutations increase the risk of HBV-related hepatocellular carcinoma: A meta-analysis. Oncotarget 2016;7(11):12525–12536. DOI: 10.18632/oncotarget.7123.
Berasain C, Castillo J, Perugorria MJ, et al. A. Inflammation and liver cancer: New molecular links. Ann N Y Acad Sci 2009;1155:206–221. DOI: 10.1111/j.1749-6632.2009.03704.x.
Dewidar B, Meyer C, Dooley S, et al. TGF-β in hepatic stellate cell activation and liver fibrogenesis – Updated 2019. Cells 2019;8(11):1419. DOI: 10.3390/cells8111419.
Budhu A, Wang XW. The role of cytokines in hepatocellular carcinoma. J Leukoc Biol 2006;80(6):1197–1213. DOI: 10.1189/jlb.0506297.
Porta C, Riboldi E, Sica A. Mechanisms linking pathogens-associated inflammation and cancer. Cancer Lett 2011;305(2):250–262. DOI: 10.1016/j.canlet.2010.10.012.
Moriyama A, Masumoto A, Nanri H, et al. High plasma concentrations of nitrite/nitrate in patients with hepatocellular carcinoma. Am J Gastroenterol 1997;92(9):1520–1523. PMID: 9317076.
Moriyama A, Tabaru A, Unoki H, et al. Plasma nitrite/nitrate concentrations as a tumor marker for hepatocellular carcinoma. Clin Chim Acta 2000;296(1–2):181–191. DOI: 10.1016/s0009-8981(00)00260-6.
Raihan R, Akbar SMF, Al Mahtab M, et al. Increased proinflammatory cytokine production by chronic hepatitis B patients with mutant hepatitis B virus: Plausible mechanisms underlying severe liver diseases in these patients. Viral Immunol 2020;33(7):530–534. DOI: 10.1089/vim.2019.0198.