title: Universal emergence of precore mutant hepatitis B virus along with seroconversion to anti-HBe irrespective of subsequent activity of chronic hepatitis B.
abstract: OBJECTIVE
  It has been controversial whether or not the emergence of precore mutant HBV is related to the severe form of chronic hepatitis B (CH-B). To further clarify the role of the precore mutant HBV in the natural course of CH-B, we conducted a longitudinal analysis of precore-region sequences according to the biochemical severity along with seroconversion to anti-HBe in patients with CH-B.
  
  
  METHODS
  The precore sequences of the ten sets of serial serum samples, obtained from 6 chronic hepatitis B patients with (group I) and from 4 patients without subsequent biochemical remission after seroconversion to anti-HBe (group II), were analyzed by direct sequencing of DNA amplified by PCR.
  
  
  RESULTS
  The precore mutant HBV having a G-A mutation at the nucleotide 1896 was most commonly found (9/10). Wild-type precore HBV was detected in 4 of 6 (66.7%) in group I and 3 of 4 (75.0%) in group II during HBeAg-positive period (p > 0.05), and during anti-HBe-positive period it was found in 2 of 6 (33.3%) in group I and 0 of 4 (0%) in group II (p > 0.05). In contrast, precore mutant HBV was detected in 5 of 6 (83.3%) in group I and 2 of 4 (50.0%) in group II during HBeAg-positive period (p > 0.05), and in all patients of both groups during anti-HBe-positive period.
  
  
  CONCLUSIONS
  The most common type of precore mutant HBV in Korea was the mutant with a G-A mutation at nucleotide 1896. The emergence of precore mutant HBV was a universal phenomenon during the natural history of CH-B; therefore, the precore mutant does not appear to have an pathogenic role in determining the severity of the CH-B.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Korea.
authors.forename: K C
authors.initials: KC
authors.lastname: Koh
authors.forename: H S
authors.initials: HS
authors.lastname: Lee
authors.forename: C Y
authors.initials: CY
authors.lastname: Kim
mesh_terms: D000328:Adult; D000595:Amino Acid Sequence; D004279:DNA, Viral / Q000235:genetics*; D005260:Female; D006509:Hepatitis B / Q000276:immunology / Q000821:virology*; D006513:Hepatitis B e Antigens / Q000096:biosynthesis*; D006515:Hepatitis B virus / Q000235:genetics* / Q000276:immunology*; D006521:Hepatitis, Chronic / Q000276:immunology / Q000821:virology*; D006801:Humans; D008297:Male; D008969:Molecular Sequence Data; D009154:Mutation; D016133:Polymerase Chain Reaction
chemical_list: D004279:DNA, Viral; D006513:Hepatitis B e Antigens