Analysis of wild-type and e antigen-defective hepatitis B viruses during the course of a short-term corticosteroid therapy in chronic hepatitis B.
Hepatitis B virus (HBV), with a G-to-a point mutation at nucleotide 83 in the precore region (mutant HBV83), accounts for most cases of hepatitis B e antigen (HBeAg)-defective HBV. However, it is still not clear how mutant HBV83 is associated with HBe seroconversion. Twenty-six HBeAg-positive patients with chronic hepatitis B who received oral prednisolone (30 mg/day) for 3 weeks were studied to clarify the prevalence of mutant HBV83 during the treatment using polymerase chain reaction with a restriction fragment length polymorphism assay. Twelve (46%) patients seroconverted to anti-HBe 1 year after treatment, whereas 14 (54%) did not. The proportion of mutant HBV83 to whole HBV remained unchanged in both groups during an acute exacerbation induced by withdrawal of corticosteroids. Among 12 anti-HBe-seroconverted patients, five (56%) of nine patients with only wild-type HBV at baseline developed detectable levels of mutant HBV83 while all three patients with a mixed viral population of wild-type HBV and mutant HBV83 at baseline developed a higher proportion of mutant HBV83 one year after treatment. In contrast, these changes were observed in only one (14%) of seven who failed to seroconvert. The results indicate that a flare-up of hepatitis precedes emergence or selection of mutant HBV83, followed by HBe seroconversion in patients with chronic hepatitis B.
Daikoku
M
M
First Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
Nakata
K
K
Hamasaki
K
K
Ido
A
A
Nakao
K
K
Kato
Y
Y
Koga
M
M
Yano
M
M
Nagataki
S
S
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001483:Base Sequence; D002908:Chronic Disease; D017931:DNA Primers; D004279:DNA, Viral / Q000097:blood / Q000187:drug effects; D005260:Female; D006509:Hepatitis B / Q000097:blood / Q000188:drug therapy / Q000821:virology*; D006513:Hepatitis B e Antigens / Q000235:genetics*; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008969:Molecular Sequence Data; D017354:Point Mutation; D016133:Polymerase Chain Reaction; D015995:Prevalence
D000305:Adrenal Cortex Hormones; D017931:DNA Primers; D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D000410:Alanine Transaminase