Published online Jan 7, 2016. doi: 10.3748/wjg.v22.i1.126
Peer-review started: May 4, 2015
First decision: August 26, 2015
Revised: September 25, 2015
Accepted: November 13, 2015
Article in press: November 13, 2015
Published online: January 7, 2016
Hepatitis B virus (HBV) has a worldwide distribution and is endemic in many populations. Due to its unique life cycle which requires an error-prone reverse transcriptase for replication, it constantly evolves, resulting in tremendous genetic variation in the form of genotypes, sub-genotypes, and mutations. In recent years, there has been considerable research on the relationship between HBV genetic variation and HBV-related pathogenesis, which has profound implications in the natural history of HBV infection, viral detection, immune prevention, drug treatment and prognosis. In this review, we attempted to provide a brief account of the influence of HBV genotype on the pathogenesis of HBV infection and summarize our current knowledge on the effects of HBV mutations in different regions on HBV-associated pathogenesis, with an emphasis on mutations in the preS/S proteins in immune evasion, occult HBV infection and hepatocellular carcinoma (HCC), mutations in polymerase in relation to drug resistance, mutations in HBV core and e antigen in immune evasion, chronicalization of infection and hepatitis B-related acute-on-chronic liver failure, and finally mutations in HBV x proteins in HCC.
Core tip: Due to the unique life cycle of hepatitis B virus (HBV) which requires an error-prone reverse transcriptase for replication, it constantly evolves resulting in significant genetic variation in the form of genotype, sub-genotype, and mutations. A large number of publications on the relationship between HBV genetic variation and HBV-related pathogenesis have appeared in recent years. However, the progress in this field has not been reviewed. We have attempted to provide a brief account of the influence of HBV genotype and mutations in the different viral genome regions on HBV-associated pathogenesis. This review provides an overview for scientists working on HBV and related fields.