Wild-type precore and core promoter sequences in patients with acute self-limited or chronic hepatitis B.
BACKGROUND
Mutations in the precore region and core promoter were compared between patients with acute and chronic hepatitis B.


METHODS
There were 69 patients with acute self-limited hepatitis B and 210 with chronic hepatitis B who had been followed for > 15 years. The hepatitis B virus (HBV) of genotypes A, B and C was detected in 14 (23%), 8 (13%) and 28 (45%) of the patients with acute self-limited hepatitis, respectively, in contrast to 11 (5%), 25 (12%) and 167 (80%) of those with chronic hepatitis.


RESULTS
At presentation, hepatitis B e antigen (HBeAg) in serum was the more common (82% versus 65%, P < 0.05), and the wild-type sequences of the precore region (100% versus 74%, P < 0.001) and core promoter (88% versus 36%, P < 0.00001) were more frequent in the 50 patients with acute self-limited hepatitis than the 203 patients with chronic hepatitis B who were infected with HBV of genotype A, B or C. Wild-types of both the precore region and core promoter persisted in acute self-limited hepatitis, while they decreased from 28% to 10% in chronic hepatitis over the course of > 15 years.


CONCLUSIONS
HBV with the wild-type sequences of the precore region and core promoter prevails in patients with acute self-limited hepatitis, unlike in patients with chronic hepatitis.
Kobayashi
M
M
Research Institute for Hepatology, Dept. of Gastroenterology, Toranomon Hospital, Tokyo, Japan. vj7m-kbys@asahi-net.or.jp
Arase
Y
Y
Ikeda
K
K
Tsubota
A
A
Suzuki
Y
Y
Saitoh
S
S
Kobayashi
M
M
Suzuki
F
F
Akuta
N
N
Hosaka
T
T
Someya
T
T
Matsuda
M
M
Sato
J
J
Miyakawa
Y
Y
Kumada
H
H
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005838:Genotype; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000097:blood / Q000235:genetics* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011401:Promoter Regions, Genetic / Q000235:genetics*
D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens