title: Clinical significance of genotypes and precore/basal core promoter mutations in HBV related chronic liver disease patients in North India.
abstract: OBJECTIVE
  Data on genotypes, basal core promoter (BCP) and precore mutants of hepatitis B virus and their association with different HBV related liver disease have been studied inadequately and are controversial. Thus, the aim of this study was to determine the incidence of BCP and precore HBV mutants and their relationship with HBV genotype and different stages of HBV related liver disease in North Indian patients.
  
  
  METHODS
  A total 273 patients with different stages of HBV related liver diseases were enrolled. Nested polymerase chain reaction (PCR) was used to amplify the BCP/PC regions. RFLP and direct sequencing were performed to validate the mutations identified in these regions. HBV genotyping was accomplished by multiplex PCR.
  
  
  RESULTS
  Genotype D was the predominant genotype found in each of the various HBV related liver diseases. The BCP mutation was found significantly more often in inactive carriers and compensated cirrhosis as compared to the other groups. The BCP mutation was present in 29.1% of patients with genotype D versus 17.1% with genotype A (P = 0.001). The precore mutation was also more frequently observed with genotype D compared with genotype A (36.9 vs. 4.8%, P = 0.0007).
  
  
  CONCLUSIONS
  Genotype D is predominant in North Indian patients. The BCP and precore mutations occur in one-third of HBV positive patients in association with the genotype D. We did not find any correlation with severity of liver disease with genotypes and mutations.
authors.affiliation: Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Sharma
authors.forename: Balkrishan
authors.initials: B
authors.lastname: Sharma
authors.forename: Bhupesh
authors.initials: B
authors.lastname: Singla
authors.forename: Yogesh Kumar
authors.initials: YK
authors.lastname: Chawla
authors.forename: Anuradha
authors.initials: A
authors.lastname: Chakraborti
authors.forename: Nitin
authors.initials: N
authors.lastname: Saini
authors.forename: Ajay
authors.initials: A
authors.lastname: Duseja
authors.forename: Ashim
authors.initials: A
authors.lastname: Das
authors.forename: Radha Krishan
authors.initials: RK
authors.lastname: Dhiman
mesh_terms: D000208:Acute Disease; D000328:Adult; D001483:Base Sequence; D005260:Female; D005838:Genotype; D006515:Hepatitis B virus / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000453:epidemiology / Q000821:virology*; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009154:Mutation; D012150:Polymorphism, Restriction Fragment Length; D011401:Promoter Regions, Genetic / Q000235:genetics*