title: Genome-wide characterisation of hepatitis B mutations involved in clinical outcome.
abstract: Infection with the hepatitis B virus (HBV) leads to different disease outcomes, which can be broadly divided into three categories: acute mild infection, 'fulminant' and chronic hepatitis (long-term persistent form of the infection). The factors that influence the development of these different disease states are poorly understood and may include viral polymorphisms. To investigate this possibility, we analysed 116 published complete HBV genomes for which we knew disease outcome and had access to associated information on patients (age, sex and geographic origin). Our best statistical model correctly classified 72% of the cases and retained age and sex of the patient, as well as 29 candidate mutations. With the exception of one mutation in the X gene, all were located in the viral polymerase, suggesting this gene plays a critical role in clinical outcome. Our results highlight the importance of the genetics of HBV strains in the evolution of the disease and demonstrate that disease outcome can be predicted to a surprisingly large extent with a limited number of host and viral factors.
authors.affiliation: Theoretical and Molecular Population Genetics group, Department of Genetics, University of Cambridge, Downing Street, Cambridge CB2 3EH, UK.
authors.forename: C
authors.initials: C
authors.lastname: Szmaragd
authors.forename: G R
authors.initials: GR
authors.lastname: Foster
authors.forename: A
authors.initials: A
authors.lastname: Manica
authors.forename: A
authors.initials: A
authors.lastname: Bartholomeusz
authors.forename: R A
authors.initials: RA
authors.lastname: Nichols
authors.forename: F
authors.initials: F
authors.lastname: Balloux
mesh_terms: D017677:Age Distribution; D004259:DNA-Directed DNA Polymerase / Q000235:genetics; D012321:DNA-Directed RNA Polymerases / Q000235:genetics; D016679:Genome, Viral; D006509:Hepatitis B / Q000235:genetics*; D006515:Hepatitis B virus / Q000235:genetics* / Q000472:pathogenicity; D006801:Humans; D009154:Mutation / Q000235:genetics*; D010802:Phylogeny; D016415:Sequence Alignment; D017678:Sex Distribution; D014764:Viral Proteins / Q000235:genetics*
chemical_list: D014764:Viral Proteins; D012321:DNA-Directed RNA Polymerases; D004259:DNA-Directed DNA Polymerase