title: Complete genome sequence of hepatitis B virus (HBV) from a patient with fulminant hepatitis without precore and core promoter mutations: comparison with HBV from a patient with acute hepatitis infected from the same infectious source.
abstract: OBJECTIVE
  There is a paucity of information regarding hepatitis B virus (HBV) from patients with fulminant hepatitis (FH) without precore (pre-C, nt 1896) and core promoter (CP, nt 1762, 1764) mutations.
  
  
  METHODS
  Pre-C and CP mutations were studied in eight patients with FH and 26 patients with acute hepatitis (AH) due to HBV. One patient with FH (FH1) was infected with HBV without these mutations. Interestingly, the sera of the infectious source (IS1) and of a patient with AH (AH1) infected from IS1 were available. Complete HBV genomes from these three patients were analyzed.
  
  
  RESULTS
  These mutations were found in seven of eight FH and five of 26 AH (P<0.01). HBV from FH1, IS1 and AH1 belonged to genotype D. Nucleotide difference between FH1 and AH1 was six of 3182 bases (nt 493, 998, 1173, 2928, 3067, and 3078). Two and five substitutions of deduced amino acid sequences were found in the pre-S1 and polymerase regions, respectively. The same nucleotide substitutions at nt 493, 1173, 2928 and 3067 were found in several patients with FH in our laboratory or GenBank.
  
  
  CONCLUSIONS
  These six nucleotide substitutions of HBV DNA could be candidates of mutations relating to FH.
authors.affiliation: Third Department of Internal Medicine, Ehime University School of Medicine, Shigenobu-cho, Onsen-gun, Ehime 791-0295, Japan.
authors.forename: Yan
authors.initials: Y
authors.lastname: Chen
authors.forename: Kojiro
authors.initials: K
authors.lastname: Michitaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsubara
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Norio
authors.initials: N
authors.lastname: Horiike
authors.forename: Morikazu
authors.initials: M
authors.lastname: Onji
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D001483:Base Sequence / Q000235:genetics; D005260:Female; D005787:Gene Frequency; D016679:Genome, Viral; D005838:Genotype; D006509:Hepatitis B / Q000503:physiopathology* / Q000821:virology*; D006515:Hepatitis B virus / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D012720:Severity of Illness Index; D014758:Viral Core Proteins / Q000235:genetics; D014764:Viral Proteins / Q000235:genetics
chemical_list: D014758:Viral Core Proteins; D014764:Viral Proteins