title: Clinical, virologic and phylogenetic features of hepatitis B infection in Iranian patients.
abstract: OBJECTIVE
  To characterize the clinical, serologic and virologic features of hepatitis B virus (HBV) infection in Iranian patients with different stages of liver disease.
  
  
  METHODS
  Sixty two patients comprising of 12 inactive carriers, 30 chronic hepatitis patients, 13 patients with liver cirrhosis and 7 patients with hepatocellular carcinoma (HCC) were enrolled in the study. The HBV S, C and basal core promoter (BCP) regions were amplified and sequenced, and the clinical, serologic, phylogenetic and virologic characteristics were investigated.
  
  
  RESULTS
  The study group consisted of 16 HBeAg-positive and 46 HBeAg-negative patients. Anti-HBe-positive patients were older and had higher levels of ALT, ASL and bilirubin compared to HBeAg-positive patients. Phylogenetic analysis revealed that all patients were infected with genotype D (mostly ayw2). The G1896A precore (PC) mutant was detected in 58.1% patients. HBeAg-negative patients showed a higher rate of PC mutant compared to HBeAg-positive patients (c2 = 9.682, P = 0.003). The majority of patients with HCC were HBeAg-negative and were infected with PC mutant variants. There was no significant difference in the occurrence of BCP mutation between the two groups, while the rate of BCP plus PC mutants was higher in HBeAg-negative patients (c2 = 4.308, P = 0.04). In the HBV S region, the genetic variability was low, and the marked substitution was P120T/S, with a rate of 9.7% (n = 6).
  
  
  CONCLUSIONS
  In conclusion, HBV/D is the predominant genotype in Iran, and the nucleotide variability in the BCP and PC regions may play a role in HBV disease outcome in HBeAg-negative patients.
authors.affiliation: Department of Genetics, Faculty of Basic Sciences, Tarbiat Modares University, Tehran, Iran.
authors.forename: Golnaz
authors.initials: G
authors.lastname: Bahramali
authors.forename: Majid
authors.initials: M
authors.lastname: Sadeghizadeh
authors.forename: Samad
authors.initials: S
authors.lastname: Amini-Bavil-Olyaee
authors.forename: Seyed-Moayed
authors.initials: SM
authors.lastname: Alavian
authors.forename: Abbas
authors.initials: A
authors.lastname: Behzad-Behbahani
authors.forename: Ahmad
authors.initials: A
authors.lastname: Adeli
authors.forename: Mohammad-Reza
authors.initials: MR
authors.lastname: Aghasadeghi
authors.forename: Safieh
authors.initials: S
authors.lastname: Amini
authors.forename: Fereidoun
authors.initials: F
authors.lastname: Mahboudi
mesh_terms: D000293:Adolescent; D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000821:virology; D002353:Carrier State; D003430:Cross-Sectional Studies; D005260:Female; D005814:Genes, Viral; D006509:Hepatitis B / Q000821:virology*; D006512:Hepatitis B Core Antigens / Q000235:genetics; D006514:Hepatitis B Surface Antigens / Q000235:genetics; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification; D019694:Hepatitis B, Chronic / Q000821:virology; D006801:Humans; D007492:Iran; D008103:Liver Cirrhosis / Q000821:virology; D008113:Liver Neoplasms / Q000821:virology; D008297:Male; D008875:Middle Aged; D009154:Mutation; D010802:Phylogeny; D055815:Young Adult
chemical_list: D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens