臨牀消化器内科 Vol.19 No.11(1-1)


特集名 B型肝炎 update 2004
題名 B型肝炎の病態 update (1) HBV genotypeと慢性肝炎の病態
発刊年月 2004年 10月
著者 藤原 圭 名古屋市立大学大学院臨床分子内科学/名古屋市立大学大学院臨床分子情報医学
著者 溝上 雅史 名古屋市立大学大学院臨床分子情報医学
【 要旨 】 1964年のオーストラリア抗原発見に始まり,serotypeによる分類を経て,現在,B型肝炎ウィルスはgenotypeによる分類が行われるようになった.それぞれのgenotypeには地域特異性・ウィルス学的な違いがあるが,最近少しずつ,genotype間の臨床的な違いが明らかとなってきた.日本においてgenotype Bはgenotype Cに比べHBe抗原陽性率が低く,予後がよいと考えられる.また,genotype Bのうちで日本とアジアにおけるsubtype Bj, Baの臨床像に違いがあることも検討されている.今後,他のgenotype, subtypeにおける臨床像の相違の検討が課題である.
Theme Hepatitis B Update 2004
Title Clinical Impact of HBV Genotypes
Author Kei Fujiwara Department of Internal Medicine and Molecular Science and Department of Clinical Molecular Informative Medicine, Nagoya City University Graduate School of Medical Sciences
Author Masashi Mizokami Department of Clinical Molecular Informative Medicine, Nagoya City University Graduate School of Medical Sciences
[ Summary ] Since the time when the Australian antigen was discovered in 1964, through the decades of serotype, hepatitis B virus (HBV) is now classified by genotype.
Each genotype has its regional and virological differences. Recently, clinical differences in genotypes have been reported. For example, there are reports that patients with the HBV genotype B have lower rates of HB e antigen positivity, lower rates of core promoter mutations, and better prognoses than those with HBV genotype C.
Also, in Asian countries, two subtypes of HBV genotype B, designated Ba (a standing for Asia) and Bj (j for Japan) have been reported. Subtype Ba has recombination with genotype C in the core promoter to core region, but subtype BJ does not. In addition clinical differences between patients infected with HBV subtype Ba and HBV subtype Bj are being recognized. In the same way, the two subtypes of genotype A have now been reported.
Other genotypes may have specific characteristics. It is essential to collect more information on HBV genotypes from all over the world to reach a decision on their clinical utility.
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