Clinical, virologic and phylogenetic features of hepatitis B infection in Iranian patients.
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.
Bahramali
Golnaz
G
Department of Genetics, Faculty of Basic Sciences, Tarbiat Modares University, Tehran, Iran.
Sadeghizadeh
Majid
M
Amini-Bavil-Olyaee
Samad
S
Alavian
Seyed-Moayed
SM
Behzad-Behbahani
Abbas
A
Adeli
Ahmad
A
Aghasadeghi
Mohammad-Reza
MR
Amini
Safieh
S
Mahboudi
Fereidoun
F
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
D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens