1. How viral genetic variants and genotypes influence disease and treatment outcome of chronic hepatitis B. Time for an individualised approach? 
Neil Rajoriya, Christophe Combet, Fabien Zoulim, Harry L.A. Janssen 
Journal of Hepatology 
Volume 67, Issue 6, Pages (December 2017)
DOI: /j.jhep
Copyright © 2017 European Association for the Study of the Liver Terms and Conditions

2. Fig. 1
Hepatitis B virus genomic variability: an unrooted phylogenetic tree representative of the nine major genotypes (A–I). Based on HBsAg heterogeneity, ten serological subtypes have been identified: ayw1, ayw2, ayw3, ayw4, ayr, adw2, adw4, adwq, adrq+ and adrq-.
Journal of Hepatology  , DOI: ( /j.jhep )
Copyright © 2017 European Association for the Study of the Liver Terms and Conditions

3. Fig. 2
Hepatitis B genome map with summary of associated mutations and downstream effects. HBV is an enveloped DNA virus, containing a partially double-stranded and relaxed-circular DNA (rcDNA) genome that replicates via the reverse transcriptase (RT) of an RNA intermediate – the pregenomic RNA (pgRNA). The genome encodes four overlapping open reading frames (ORFs) that translate into HB proteins. Dependent on the region of mutation, impacts upon the downstream effects, such as PC/BCP* mutations or other mutations, can lead to B-cell immune escape, tumourigenesis and drug resistance to the older drugs such as adefovir and lamivudine. C, core; CTL, cytotoxic T-lymphocyte; ds, double-stranded; HBc, hepatitis B core; HBeAg, Hepatitis B e antigen; HBs, hepatitis B surface; MHR, major hydrophilic region; P, polymerase; PreC, Pre-Core; RT; reverse transcriptase; S, surface.
Journal of Hepatology  , DOI: ( /j.jhep )
Copyright © 2017 European Association for the Study of the Liver Terms and Conditions

4. Fig. 3
The original epidemiology of Hepatitis B virus genotypes. With immigration patterns HBV genotypes have spread out over the globe. Particularly in Europe and North America where HBV infection is predominant in a migrant population, the HBV genotypes often reflects the patient’s country of origin. HBV, hepatitis B virus.
Journal of Hepatology  , DOI: ( /j.jhep )
Copyright © 2017 European Association for the Study of the Liver Terms and Conditions

5. Fig. 4
Personalised medicine approach to the future treatment of Hepatitis B infection. The aims of personalised medicine are to inform decision making between patient and clinician to halt the progression of liver disease and prevent complications in those affected with chronic HBV infection. Factors involved in personalised medicine can range between viral, clinical and patient factors. Viral factors include the important effect of genotype in chronicity, progression, treatment response and HCC formation. PC and BCP mutations play a strong role in outcome of disease, whilst HBV mutation analysis, biomarkers and assessment for drug resistance in the future may play a key role in individualizing treatment per patient. Clinician and patient factors will remain key in decisions between the two in strategizing treatment options but also in deciding which patients may be at risk of hepatitis B disease complications. Treatment availability and cost can vary geographically whilst newer technologies to inform decisions such as NGS, mass spectrometry and mathematical modelling may allow for identification as to which patient may benefit from treatment. *12 and 24week stopping rules in patients treated with PEG-IFN as per EASL 2017 guidelines (102). BCP, basal core promoter; HBsAg, hepatitis B surface antigen; HBV, hepatitis B virus; HCC, hepatocellular carcinoma; NGS, next-generation sequencing; PC, pre-core; PEG-IFN, pegylated interferon.
Journal of Hepatology  , DOI: ( /j.jhep )
Copyright © 2017 European Association for the Study of the Liver Terms and Conditions