title: Clinical significance of the genotype and core promoter/pre-core mutations in hepatitis B virus carriers.
abstract: It has been shown that clinical and virological characteristics vary among hepatitis B virus (HBV) genotypes. In this study, we measured the virus level, disease severity, and presence or absence of core promoter (CP)/pre-core (PC) mutations in 241 HBV carriers, and investigated the clinical significance of measuring the HBV genotype. In genotype C HBV carriers, the proportion of hepatitis B e antigen (HBeAg)-positive patients was significantly higher than that in genotype B HBV carriers (0 vs. 34.4%, p < 0.05), and the virus level was higher (4.9 vs. 4.05 LGE/ml). In the genotype B HBV carriers, the incidence of PC mutation was significantly higher (69 vs. 34%, p < 0.05). In the genotype C HBV carriers, the incidence of CP mutation was significantly higher (13 vs. 78%, p < 0.05). We compared patients with the wild (W)/mutant (M) pattern in the CP/PC regions to those with the M/W pattern in the CP/PC regions among the genotype C HBV carriers. Both the proportion of HBeAg-positive patients (65.8 vs. 15.4%, p < 0.05) and the alanine aminotransferase (ALT) level (48 vs. 21.5 IU, p < 0.05) were higher in the patients with the M/W pattern in the CP/PC regions, and the disease severity was deteriorated. In conclusion, genotype B HBV may more frequently induce HBe seroconversion via PC mutation compared to genotype C HBV. Among the genotype C HBV carriers, hepatitis activity and the deterioration of the disease severity were significantly inhibited in the group in which PC mutation initially occurred, in comparison to the group in which CP mutation initially occurred.
authors.affiliation: Department of Gastroenterology and Hepatology, Kinki University, School of Medicine, Osaka, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Hagiwara
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Minami
authors.forename: Hobyung
authors.initials: H
authors.lastname: Chung
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nakatani
authors.forename: Toyokazu
authors.initials: T
authors.lastname: Fukunaga
authors.forename: Yukio
authors.initials: Y
authors.lastname: Osaki
authors.forename: Yukitaka
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Kozo
authors.initials: K
authors.lastname: Kajimura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002353:Carrier State; D005260:Female; D005838:Genotype; D006509:Hepatitis B / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology*; D006511:Hepatitis B Antigens / Q000235:genetics*; D006512:Hepatitis B Core Antigens / Q000235:genetics*; D006515:Hepatitis B virus / Q000145:classification / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017354:Point Mutation; D011401:Promoter Regions, Genetic
chemical_list: D006511:Hepatitis B Antigens; D006512:Hepatitis B Core Antigens