title: Impact of determination of hepatitis B virus subgenotype and pre-core/core-promoter mutation for the prediction of acute exacerbation of asymptomatic carriers.
abstract: OBJECTIVE
  A large cohort study in Japan revealed that the specific viral profile may influence the fulminant outcome in acute hepatitis B virus (HBV) infections, while the genetic influence on outcome has not been clarified in patients with acute exacerbation of chronic liver disease caused by HBV. We experienced a case of fatal liver failure that developed as the result of chronic HBV infection. To determine possible genetic factor involving acute exacerbation, genetic analysis of serum from the patient and his siblings was performed.
  
  
  METHODS
  HBV subgenotype as well as pre-core/core-promoter mutations of samples mentioned above were determined.
  
  
  RESULTS
  Patient had HBV-Bj with pre-core (1896/1899) and core-promoter (1762/1764) mutations, the genomic profile frequently seen in fulminant hepatitis caused by acute HBV infection.
  
  
  CONCLUSIONS
  This result suggests that determination of the HBV subgenotype and pre-core/core promoter mutations could provide a rationale for development of a treatment strategy in asymptomatic HBV carriers.
authors.affiliation: Division of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Ikegami
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Matsuki
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Masashi
authors.initials: M
authors.lastname: Mizokami
authors.forename: Akira
authors.initials: A
authors.lastname: Honda
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hirayama
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Saito
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Matsuzaki