Introduction. HBV genotypes and subtypes are useful clinical and epidemiological markers. In this study prevalent HBV genotypes were assessed in relation to serological profile and clinical status. Material & Methods. 107 cases of HBV were genotyped. Detailed clinical history was elicited from them. HBsAg, HBeAg, anti-HBs, anti-HBe, and anti-HBc-IgM were assessed. HBV genotyping was performed using Kirschberg's type specific primers (TSP-PCR), heminested PCR, and Naito's monoplex PCR. Nucleotide sequencing was performed. Results. A total of 97 (91%) were genotyped following the methods of Kirschberg et al./Naito et al. Genotype D was by far the most prevalent genotype 91 (85.04%) in this region. A surprising finding was the detection of genotype F in 5 (4.67%) of our patients. Genotype A strangely was observed only in one case. In 85.7% genotype D was associated with moderate to severe liver disease, 43.9% HBeAg, and 18.7% anti-HBc-IgM positivity. Majority of genotype F (80%) was seen in mild to moderate liver disease. It was strongly associated with HBeAg 60% and 20% anti-HBc-IgM positivity. Conclusion. Emergence of genotype F in India merits further study regarding its clinical implications and treatment modalities. Knowledge about HBV genotypes can direct a clinician towards more informed management of HBV patients. 1. Introduction Hepatitis B virus (HBV) is one of the major public health problems worldwide. About 30% of the world population has serological evidence of current and past infection with HBV  and approximately 1 million persons die annually from HBV related chronic liver diseases including severe complications such as liver cirrhosis and hepatocellular carcinoma . Every year there are over 4 million acute clinical cases of HBV and about 25% of carriers. Approximately one million people a year die from chronic active hepatitis, cirrhosis, or primary liver cancer . Genotypically, HBV is divided into 8 groups, A–H. HBV genotypes represent naturally occurring strains of HBV that have evolved over the years in the world. The genotypes and subtypes were identified on the basis of intergroup divergence of 8% or 4% in gene (S) sequence, respectively. They are useful clinical and epidemiological markers . It is also well known that genotypes vary geographically and correlate strongly with ethnicity . Genotype correlation has been associated with HBV core antigen, HBe antigen seroconversion, activity of liver disease, and treatment response with chronic HBV infections [6, 7]. Type A is prevalent in Europe, Africa, and southeast
E. Szabó, C. Páska, P. K. Novák, Z. Schaff, and A. Kiss, “Similarities and differences in hepatitis B and C virus induced hepatocarcinogenesis,” Pathology and Oncology Research, vol. 10, no. 1, pp. 5–11, 2004.
World Health Organization, Introduction of Hepatitis B Vaccine into Childhood Immunization Services, Unpublished Document WHO/V&B/01.31, Department of Vaccines and Biologicals, World Health Organization, Geneva, Switzerland, 2001.
H. Norder, B. Hammas, S. Lofdahl, A. M. Courouce, and L. O. Magnius, “Comparison of the amino acid sequences of nine different serotypes of hepatitis B surface antigen and genomic classification of the corresponding hepatitis B virus strains,” Journal of General Virology, vol. 73, part 5, pp. 1201–1208, 1992.
P. Arauz-Ruiz, H. Norder, B. H. Robertson, and L. O. Magnius, “Genotype H: a new Amerindian genotype of hepatitis B virus revealed in Central America,” Journal of General Virology, vol. 83, no. 8, pp. 2059–2073, 2002.
C. Grandjacques, P. Pradat, L. Stuyver et al., “Rapid detection of genotypes and mutations in the pre-core promoter and the pre-core region of hepatitis B virus genome: correlation with viral persistence and disease severity,” Journal of Hepatology, vol. 33, no. 3, pp. 430–439, 2000.
H. Naito, S. Hayashi, and K. Abe, “Rapid and specific genotyping system for hepatitis B virus corresponding to six major genotypes by PCR using type-specific primers,” Journal of Clinical Microbiology, vol. 39, no. 1, pp. 362–364, 2001.
S. Usuda, H. Okamoto, H. Iwanari et al., “Serological detection of hepatitis B virus genotypes by ELISA with monoclonal antibodies to type-specific epitopes in the preS2-region product,” Journal of Virological Methods, vol. 80, no. 1, pp. 97–112, 1999.
P. Vivekanandan, P. Abraham, G. Sridharan et al., “Distribution of hepatitis B virus genotypes in blood donors and chronically infected patients in a tertiary care hospital in Southern India,” Clinical Infectious Diseases, vol. 38, no. 9, pp. e81–e86, 2004.
V. Thakur, R. C. Guptan, S. N. Kazim, V. Malhotra, and S. K. Sarin, “Profile, spectrum and significance of HBV genotypes in chronic liver disease patients in the Indian subcontinent,” Journal of Gastroenterology and Hepatology, vol. 17, no. 2, pp. 165–170, 2002.
S. S. Gandhe, M. S. Chadha, and V. A. Arankalle, “Hepatitis B virus genotypes and serotypes in Western India: lack of clinical significance,” Journal of Medical Virology, vol. 69, no. 3, pp. 324–330, 2003.
A. Banerjee, F. Kurbanov, S. Datta et al., “Phylogenetic relatedness and genetic diversity of hepatitis B virus isolates in Eastern India,” Journal of Medical Virology, vol. 78, no. 9, pp. 1164–1174, 2006.
A. Kumar, S. I. Kumar, R. Pandey, S. Naik, and R. Aggarwal, “Hepatitis B virus genotype A is more often associated with severe liver disease in northern India than is genotype D,” Indian Journal of Gastroenterology, vol. 24, no. 1, pp. 19–22, 2005.
M. V. A. Mora, C. M. Romano, M. S. Gomes-Gouvêa et al., “Molecular characterization of the Hepatitis B virus genotypes in Colombia: a Bayesian inference on the genotype F,” Infection, Genetics and Evolution, vol. 11, no. 1, pp. 103–108, 2011.
M. Devesa, C. L. Loureiro, Y. Rivas et al., “Subgenotype diversity of hepatitis B virus American genotype F in Amerindians from Venezuela and the general population of Colombia,” Journal of Medical Virology, vol. 80, no. 1, pp. 20–26, 2008.
J. Singh, V. Pahal, and R. Kumar, “First report of genotype F and novel mutations in the core promoter region of HBV isolates from a Northern Indian population,” Cancer Prevention Research, vol. 1, no. 7, supplement, 2008.
R. E. F. Rezende, B. A. L. Fonseca, L. N. Z. Ramalho et al., “The precore mutation is associated with severity of liver damage in Brazilian patients with chronic hepatitis B,” Journal of Clinical Virology, vol. 32, no. 1, pp. 53–59, 2005.
A. A. Abdo, B. M. Al-Jarallah, F. M. Sanai et al., “Hepatitis B genotypes: relation to clinical outcome in patients with chronic hepatitis B in Saudi Arabia,” World Journal of Gastroenterology, vol. 12, no. 43, pp. 7019–7024, 2006.
A. Tsubota, Y. Arase, F. Ren, H. Tanaka, K. Ikeda, and H. Kumada, “Genotype may correlate with liver carcinogenesis and tumor characteristics in cirrhotic patients infected with hepatitis B virus subtype adw,” Journal of Medical Virology, vol. 65, no. 2, pp. 257–265, 2001.
C. T. Wai, R. J. Fontana, J. Polson et al., “Clinical outcome and virological characteristics of hepatitis B-related acute liver failure in the United States,” Journal of Viral Hepatitis, vol. 12, no. 2, pp. 192–198, 2005.
A. R. N. Zekri, M. M. Hafez, N. I. Mohamed et al., “Hepatitis B virus (HBV) genotypes in Egyptian pediatric cancer patients with acute and chronic active HBV infection,” Virology Journal, vol. 4, article 74, 2007.
S. E. Livingston, J. P. Simonetti, B. J. McMahon et al., “Hepatitis B virus genotypes in Alaska Native people with hepatocellular carcinoma: preponderance of genotype F,” Journal of Infectious Diseases, vol. 195, no. 1, pp. 5–11, 2007.
J. M. Sánchez-Tapias, J. Costa, A. Mas, M. Bruguera, and J. Rodés, “Influence of hepatitis B virus genotype on the long-term outcome of chronic hepatitis B in western patients,” Gastroenterology, vol. 123, no. 6, pp. 1848–1856, 2002.