title: Role of genotype and precore/basal core promoter mutations of hepatitis B virus in patients with chronic hepatitis B with acute exacerbation.
abstract: OBJECTIVE
  The results of long-term, follow-up studies show that the severity and frequency of acute exacerbation of chronic hepatitis B virus (HBV) are associated with the development of liver cirrhosis in chronic HBV infection. The aim of this study was to investigate the relationship between virological factors of HBV and the severity of acute exacerbation.
  
  
  METHODS
  Fifty-one chronic hepatitis B patients with symptomatic acute exacerbation without antiviral therapy were enrolled in the study. Genotype of HBV was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Precore (A1896) and basal core promoter (BCP) mutations (T1762 & A1764) were determined by PCR and direct sequencing.
  
  
  RESULTS
  Thirty-nine patients had genotype B, 11 patients had genotype C, and 1 patient had an unclassified genotype. Thirty-two patients had precore mutation and 24 patients had BCP mutation. After adjusting for age, gender, aspartate aminotransferase (ASAT) level, albumin level, and platelet count by multiple logistic regression test, precore mutation had a protective effect on the occurrence of hepatic decompensation (p=0.046), and genotype and BCP mutations were not associated with the occurrence of hepatic decompensation.
  
  
  CONCLUSIONS
  HBV precore mutation may confer less severe liver disease during acute exacerbation of chronic HBV. Genotype and BCP mutations did not have a significant association with the occurrence of hepatic decompensation.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: Wei-Lun
authors.initials: WL
authors.lastname: Tsai
authors.forename: Gin-Ho
authors.initials: GH
authors.lastname: Lo
authors.forename: Ping-I
authors.initials: PI
authors.lastname: Hsu
authors.forename: Kwok-Hung
authors.initials: KH
authors.lastname: Lai
authors.forename: Chiun-Ku
authors.initials: CK
authors.lastname: Lin
authors.forename: Hoi-Hung
authors.initials: HH
authors.lastname: Chan
authors.forename: Wen-Chi
authors.initials: WC
authors.lastname: Chen
authors.forename: Jin-Shiung
authors.initials: JS
authors.lastname: Cheng
authors.forename: Yung-Ching
authors.initials: YC
authors.lastname: Liu
authors.forename: Tsi-Shu
authors.initials: TS
authors.lastname: Huang
authors.forename: Luo-Ping
authors.initials: LP
authors.lastname: Ger
authors.forename: Hsi-Hsun
authors.initials: HH
authors.lastname: Lin
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D005260:Female; D005838:Genotype; D006512:Hepatitis B Core Antigens / Q000235:genetics*; D006515:Hepatitis B virus / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000503:physiopathology* / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017354:Point Mutation; D012150:Polymorphism, Restriction Fragment Length; D011401:Promoter Regions, Genetic / Q000235:genetics; D012720:Severity of Illness Index
chemical_list: D006512:Hepatitis B Core Antigens