Basal core-promoter mutant of hepatitis B virus and progression of liver disease in hepatitis B e antigen-negative chronic hepatitis B.
OBJECTIVE
The long-term outcomes in hepatitis B e antigen (HBeAg)-negative chronic hepatitis B are distinct from those in HBeAg-positive chronic hepatitis. However, the molecular virological factors that contribute to the progression of liver disease in this special clinical setting remain largely unknown. We thus investigated the association of hepatitis B virus (HBV) genotypes as well as precore/basal core-promoter mutations with the clinical and virological characteristics of patients with HBeAg-negative chronic hepatitis B in Taiwan.


METHODS
HBV genotypes and sequences of precore and basal core-promoter regions of the HBV genome were determined in 174 HBeAg-negative chronic HBV infection patients including 62 inactive carriers and 112 with different stages of liver disease.


RESULTS
HBV carriers with older age (> 50 years) (odds ratio, 9.09; 95% confidence interval (CI), 3.22-25, P < 0.001) and basal core-promoter mutant of HBV (odds ratio, 4.12; 95% CI, 1.41-12.03, P = 0.01) were associated with the development of liver cirrhosis and hepatocellular carcinoma (HCC). The gender-related risk factors associated with the development of liver cirrhosis and HCC were further analyzed, and basal core-promoter mutant was only associated with the development of liver cirrhosis and HCC in male carriers (odds ratio, 4.35; 95% CI, 1.30-14.52, P = 0.02).


CONCLUSIONS
The risk of development of liver cirrhosis and HCC is significantly increased in patients with advanced age as well as with basal core-promoter mutant of HBV. In addition, basal core-promoter mutant might contribute to the gender difference of the progression of liver disease in HBeAg-negative chronic hepatitis B in Taiwan.
Lin
Chih-Lin
CL
Department of Gastroenterology, Taipei Municipal Jen-Ai Hospital, Taipei, Taiwan.
Liao
Li-Ying
LY
Wang
Chaur-Shine
CS
Chen
Pei-Jer
PJ
Lai
Ming-Yang
MY
Chen
Ding-Shinn
DS
Kao
Jia-Horng
JH
D000328:Adult; D017677:Age Distribution; D000368:Aged; D002353:Carrier State / Q000821:virology; D018450:Disease Progression; D005260:Female; D005838:Genotype; D006513:Hepatitis B e Antigens / Q000235:genetics*; D006515:Hepatitis B virus / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology*; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000503:physiopathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D011401:Promoter Regions, Genetic / Q000235:genetics; D012307:Risk Factors; D017678:Sex Distribution; D013624:Taiwan / Q000453:epidemiology
D006513:Hepatitis B e Antigens