title: Type B fulminant hepatitis is closely associated with a highly mutated hepatitis B virus strain.
abstract: OBJECTIVE
  Genome-wide sequences of hepatitis B virus strain associated with type B fulminant hepatitis have not been compared with those of acute self-limited hepatitis. We carried out full-length sequencing analysis of viral strains derived from patients with type B acute liver injury.
  
  
  METHODS
  Nine acute self-limited hepatitis and 6 fulminant hepatitis patients were the subjects of this study. Full-length sequencing analysis of viral DNA was done by PCR-direct sequencing.
  
  
  RESULTS
  Higher frequencies in fulminant hepatitis strains compared with acute hepatitis ones were observed in the T1762/A1764 (p < 0.05), A1896 (p = 0.09) and M1753 (M = C or A) (p = 0.09) mutations. Viruses related to fulminant hepatitis possessed the higher number of nucleotide substitutions than those related to acute hepatitis in the whole virus genome (p < 0.01) and various regions including preS/S gene (p < 0.05), precore/core gene (p < 0.01), polymerase gene (p < 0.05) and basic core promoter/core upstream regulatory sequence (p < 0.01). The high number of nucleotide substitutions in viruses related to fulminant hepatitis was predominantly non-synonymous in the preS/S and precore/core genes.
  
  
  CONCLUSIONS
  Development of type B fulminant hepatitis may be associated with a highly mutated hepatitis B virus strain.
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Aimi
authors.initials: A
authors.lastname: Kanada
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Takehara
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Ohkawa
authors.forename: Tomohide
authors.initials: T
authors.lastname: Tatsumi
authors.forename: Ryotaro
authors.initials: R
authors.lastname: Sakamori
authors.forename: Shinjiro
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Akio
authors.initials: A
authors.lastname: Uemura
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kohga
authors.forename: Akira
authors.initials: A
authors.lastname: Sasakawa
authors.forename: Hayato
authors.initials: H
authors.lastname: Hikita
authors.forename: Taizo
authors.initials: T
authors.lastname: Hijioka
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Katayama
authors.forename: Matsuo
authors.initials: M
authors.lastname: Deguchi
authors.forename: Masanori
authors.initials: M
authors.lastname: Kagita
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kanto
authors.forename: Naoki
authors.initials: N
authors.lastname: Hiramatsu
authors.forename: Norio
authors.initials: N
authors.lastname: Hayashi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000595:Amino Acid Sequence; D003062:Codon / Q000235:genetics*; D004279:DNA, Viral / Q000032:analysis / Q000737:chemistry; D005260:Female; D016679:Genome, Viral; D006512:Hepatitis B Core Antigens / Q000235:genetics; D006515:Hepatitis B virus / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D017114:Liver Failure, Acute / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D017422:Sequence Analysis, DNA
chemical_list: D003062:Codon; D004279:DNA, Viral; D006512:Hepatitis B Core Antigens