Chronic hepatitis B virus (HBV) infection remains a global problem. Several HBV genotypes exist with different biology and geographical prevalence. Whilst the future aim of HBV treatment remains viral eradication, current treatment strategies aim to suppress the virus and prevent the progression of liver disease. Current strategies also involve identification of patients for treatment, namely those at risk of progressive liver disease. Identification of HBV genotype, HBV mutants and other predictive factors allow for tailoured treatments, and risk-surveillance pathways, such as hepatocellular cancer screening. In the future, these factors may enable stratification not only of treatment decisions, but also of patients at risk of higher relapse rates when current therapies are discontinued. Newer technologies, such as next-generation sequencing, to assess drug-resistant or immune escape variants and quasi-species heterogeneity in patients, may allow for more information-based treatment decisions between the clinician and the patient. This article serves to discuss how HBV genotypes and genetic variants impact not only upon the disease course and outcomes, but also current treatment strategies. Adopting a personalised genotypic approach may play a role in future strategies to combat the disease. Herein, we discuss new technologies that may allow more informed decision-making for response guided therapy in the battle against HBV.

中文翻译：

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病毒遗传变异和基因型如何影响慢性乙型肝炎的疾病和治疗结果。个体化方法的时间？

慢性乙型肝炎病毒 (HBV) 感染仍然是一个全球性问题。存在几种具有不同生物学和地理流行性的 HBV 基因型。虽然 HBV 治疗的未来目标仍然是根除病毒，但目前的治疗策略旨在抑制病毒并防止肝病进展。目前的策略还涉及确定患者进行治疗，即那些有进展性肝病风险的患者。HBV 基因型、HBV 突变体和其他预测因素的鉴定允许进行量身定制的治疗和风险监测途径，例如肝细胞癌筛查。将来，这些因素不仅可以对治疗决策进行分层，而且可以对当前治疗中断时有较高复发率风险的患者进行分层。新一代测序等新技术，评估患者的耐药或免疫逃逸变异和准物种异质性，可能允许临床医生和患者之间做出更多基于信息的治疗决策。本文旨在讨论 HBV 基因型和遗传变异如何不仅影响病程和结果，而且还影响当前的治疗策略。采用个性化的基因型方法可能会在未来对抗该疾病的策略中发挥作用。在此，我们讨论了新技术，这些技术可能允许在抗击 HBV 的战斗中为反应指导治疗做出更明智的决策。本文旨在讨论 HBV 基因型和遗传变异如何不仅影响病程和结果，而且还影响当前的治疗策略。采用个性化的基因型方法可能会在未来对抗该疾病的策略中发挥作用。在此，我们讨论了新技术，这些技术可能允许在抗击 HBV 的战斗中为反应指导治疗做出更明智的决策。本文旨在讨论 HBV 基因型和遗传变异如何不仅影响病程和结果，而且还影响当前的治疗策略。采用个性化的基因型方法可能会在未来对抗这种疾病的策略中发挥作用。在此，我们讨论了新技术，这些技术可能允许在抗击 HBV 的战斗中为反应指导治疗做出更明智的决策。