Meta-analysis In Distribution Of Hepatitis B Virus Genotypes And Related Clinical Outcomes In China

Background Hepatitis B virus(HBV)infection is seriously damaged to human health.Along with the deeply understanding of hepatitis B virus,more and more attention have been paid to hepatitis B virus.Geographic and demographic distributions of hepatitis B virus(HBV)genotypes in China may be distinct because of regional differences in population,ethnicity,HBV infection rates,and lifestyles.The aim of this study was to investigate geographic and national distributions of HBV genotypes in China and to uncover the association of HBV genotypes and clinical outcomes of various liver diseases.The findings of this study are expected to be useful in evaluating future disease burdens of HBV infections and development of control strategies.Methods Studies on HBV genotypes in China were searched by the Wanfang and NCBI databases from year 2000 to 2014,then according to the included and exclusion criteria,classified collected literature by different regions,ethnicity,and category of liver diseases,and the data of these studies were analyzed by meta-analysis to observe the distribution of genotypes and related clinical significance in each classification.Results In China,genotypes B and genotype C were the main genotype.The HBV A,B,C,B/C,D and other genotype infection in patients in area 1(the North area)were 0.1%,22.2%,69.1%,3.8%,0.5% and 1.5%,with C genotype significantly higher than patients in the other areas(P<0.05);The HBV A,B,C,B/C,D and other genotype infection in patients in area 2(the Central area)were 0.2%,62.6%,27.4%,3.8%,0.5%and 2.4%,with B genotype significantly higher than patients in the other areas (P<0.05);In area 3(the South area),the HBV A,B,C,B/C,D and other genotype infection were 0.6%,36.3%,49.4%,2.8%,2.6% and 3.4%,with C genotype significantly higher than patients in area 2(27.4%,P<0.05);In area 4(the Qinghai-Tibet plateau),the HBV B,C,D and other genotype infection were 6.0%,22.5%,11.7%,59.3%,with C/D genotype significantly higher than patients in the other areas(all P<0.05);Additionally,genotype distribution among different nationalities was significantly different.Genotype C/D recombinant(49.3%)in the Tibetan population was significantly higher than patients in other nationalities(all P<0.05),genotype D in Kazak(58.1%)was significantly higher than patients in other nationalities(all P<0.05).Furthermore,use asymptomatic carriers as control group,genotype C was significantly positively correlated with chronic hepatitis B,HBV related liver cirrhosis and hepatocellular carcinoma(Odds ratios: 1.979,3.888,4.399,all P<0.001).Conclusion The main genotype in China was genotype B and genotype C,genotype C predominated South and North regions,while genotype B predominated the Central region,the distributions of HBV genotypes in different regions and nationalities were significantly different,and the findings of this study suggest that genotype B was the original strain of Chinese HBV.At the same time,this study suggested that the main hepatitis B virus genotypes in the Tibetan people was C/D recombinant,C genotype and D genotype predominate in hui nationality and the uygur people,D genotypes were mainly distributed in kazak people.In addition,studies have shown that genotype C was more likely to cause severe liver damage,such as liver cirrhosis and hepatocellular carcinoma.