Hepatitis B virus X mutations occurring naturally associated with clinical severity of liver disease among Korean patients with chronic genotype C infection.
Few reports have detailed mutation frequencies and mutation patterns in the entire X region according to clinical status. The aims of this study were to elucidate the relationships between mutation patterns and their frequencies in the X region and clinical status in a Korean cohort and determine specific X mutation types, related closely with liver disease progression. All X mutations were determined by direct sequencing in 184 patients with different clinical features. Mutation rates in the X region in patients with more severe liver disease, hepatocellular carcinoma (HCC) (3.6%) or liver cirrhosis (4%) were always significantly higher than in patients with corresponding less severe forms, chronic hepatitis (2.9%) or asymptomatic carriers (2.1%), but no significant difference in mutation rates was found in terms of HBeAg serostatus. All five mutation types (V5M/L, P38S, H94Y, I127T/N, and K130M and V131I) affecting the six codons were found to be related significantly to clinical severity. Among these, two mutation types (V5M/L and K130M and V131I) were observed more frequently in HBeAg negative patients than in HBeAg positive patients. In conclusion, the results suggest that an accumulation of mutations in the X region contributes to disease progression in chronic patients, at least Korean patients with genotype C. Specific mutation types appears to be related more to severe liver diseases such as HCC or liver cirrhosis. In particular, a novel mutation type (V5M/L) discovered firstly during the present study was found to be associated significantly with HCC.
Kim
Hyun-Ju
HJ
Department of Microbiology and Immunology, Liver Research Institute and Cancer Research Institute, College of Medicine, Seoul National University, Seoul, Korea.
Park
Joo-Hee
JH
Jee
Youngmee
Y
Lee
Seoung-Ae
SA
Kim
Hong
H
Song
Byung-Cheol
BC
Yang
Soohyun
S
Lee
Myunghee
M
Yoon
Jung-Hwan
JH
Kim
Yoon Jun
YJ
Lee
Hyo-Suk
HS
Hwang
Eung-Soo
ES
Kook
Yoon-Hoh
YH
Kim
Bum-Joon
BJ
D000328:Adult; D000368:Aged; D000595:Amino Acid Sequence; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000503:physiopathology / Q000821:virology; D005260:Female; D005838:Genotype; D006515:Hepatitis B virus / Q000145:classification* / Q000235:genetics* / Q000472:pathogenicity; D019694:Hepatitis B, Chronic / Q000453:epidemiology / Q000503:physiopathology* / Q000821:virology; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000503:physiopathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009154:Mutation; D015995:Prevalence; D012720:Severity of Illness Index; D015534:Trans-Activators / Q000235:genetics*; D054334:Viral Regulatory and Accessory Proteins
D015534:Trans-Activators; D054334:Viral Regulatory and Accessory Proteins; C057628:hepatitis B virus X protein