Precore and core promoter mutations, hepatitis B virus DNA levels and progressive liver injury in chronic hepatitis B

To elucidate the viral factors responsible for progressive liver injury in chronic hepatitis B. We analyzed 179 persistently infected patients (21 asymptomatic carriers, 126 with chronic hepatitis and 32 with cirrhosis) with genotype C hepatitis B virus (HBV). HBeAg/anti-HBe, levels of HBV DNA, muta...

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Bibliographic Details
Published in:Journal of hepatology 2002-09, Vol.37 (3), p.355-363
Main Authors: YOTSUYANAGI, Hiroshi, HINO, Kunihiko, TOMITA, Eiichi, TOYODA, Joji, YASUDA, Kiyomi, IINO, Shiro
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
DNA, Viral - blood
Female
Genotype
Hepatitis B Core Antigens - genetics
Hepatitis B virus - genetics
Hepatitis B, Chronic - pathology
Hepatitis B, Chronic - virology
Human viral diseases
Humans
Infectious diseases
Liver Cirrhosis - pathology
Liver Cirrhosis - virology
Male
Medical sciences
Middle Aged
Point Mutation
Promoter Regions, Genetic - genetics
Viral diseases
Viral hepatitis
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Summary:To elucidate the viral factors responsible for progressive liver injury in chronic hepatitis B. We analyzed 179 persistently infected patients (21 asymptomatic carriers, 126 with chronic hepatitis and 32 with cirrhosis) with genotype C hepatitis B virus (HBV). HBeAg/anti-HBe, levels of HBV DNA, mutations in the basic core promoter (BCP) region at nucleotides 1762/1764 and mutation in the precore (preC) region at nucleotide 1896 were determined. Serial samples from 18 patients also were analyzed. HBeAg/anti-HBe and HBV DNA levels per se were not related to liver fibrosis. The frequency of BCP mutations increased with progression of liver fibrosis. Although the preC mutation was detected more often among the LC group, the role of this mutation in progression of fibrosis seems less than that of the BCP mutations. Sequential analysis showed that (1) rapidly progressing cases were positive continuously for double mutations in the BCP with a wild-type precore sequence, and (2) asymptomatic cases with anti-HBe acquired the preC mutation during their clinical course. Double mutations in the BCP region at nucleotide 1762/1764 are closely related to progression of chronic liver disease. Acquisition of mutation in the preC region at nucleotide 1896 may contribute to inactivation of chronic liver disease.
ISSN:0168-8278
1600-0641
DOI:10.1016/s0168-8278(02)00180-0