title: Features and clinical implications of hepatitis B virus genotypes and mutations in basal core promoter/precore region in 507 Chinese patients with acute and chronic hepatitis B.
abstract: BACKGROUND
  The association of hepatitis B virus (HBV) genotypes and basal core promoter (BCP) and precore (PC) mutations with the clinical characteristics is increasingly recognized.
  
  
  OBJECTIVE
  To investigate virologic features and clinical implications of HBV genotypes, BCP and PC mutations between large-size patients with acute hepatitis B (AHB) and chronic hepatitis B (CHB).
  
  
  METHODS
  One hundred and eighty-two AHB patients and 325 CHB patients were investigated. HBV genotypes and BCP/PC mutations were determined by direct sequencing. Mutations at 10 interested sites of the BCP/PC region were compared between the two groups of patients.
  
  
  RESULTS
  AHB patients had a significantly higher ratio of genotype B to C than CHB patients (37.4-62.6% vs. 16.6-83.4%, P<0.001). The prevalence of BCP/PC wild-type virus was 60.4% in AHB patients in contrast to 28.9% in CHB patients. Significantly lower prevalence of A1762T, G1764A, G1896A, and G1899A but higher prevalence of T1758C was found in AHB patients. Interestingly, T1758C and A1762T/G1764A appeared mutual restraint. Genotype B virus had lower BCP mutation frequency and similar PC mutation frequency compared to genotype C virus. AHB patients with BCP/PC mutant virus had higher viral load, whereas CHB patients with BCP/PC mutant virus had lower viral load and elevated alanine aminotransferase, in comparison with those with the wild-type virus.
  
  
  CONCLUSIONS
  Patients with genotype B virus, BCP/PC wild-type virus or T1758C mutant virus were more susceptible to develop AHB, whereas high prevalence of the BCP/PC mutations was associated with CHB development.
authors.affiliation: Viral Hepatitis Research Laboratory, Institute of Infectious Diseases, Beijing 302 Hospital, Beijing 100039, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.forename: Yanwei
authors.initials: Y
authors.lastname: Zhong
authors.forename: Zhengsheng
authors.initials: Z
authors.lastname: Zou
authors.forename: Zhihui
authors.initials: Z
authors.lastname: Xu
authors.forename: Baosen
authors.initials: B
authors.lastname: Li
authors.forename: Xiaoqiang
authors.initials: X
authors.lastname: Ren
authors.forename: Siyu
authors.initials: S
authors.lastname: Bai
authors.forename: Lin
authors.initials: L
authors.lastname: Wang
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Li
authors.forename: Jiuzeng
authors.initials: J
authors.lastname: Dai
authors.forename: Yao
authors.initials: Y
authors.lastname: Wang
authors.forename: Panyong
authors.initials: P
authors.lastname: Mao
authors.forename: Dongping
authors.initials: D
authors.lastname: Xu
mesh_terms: D000328:Adult; D002681:China; D005260:Female; D005838:Genotype; D006509:Hepatitis B / Q000473:pathology* / Q000821:virology*; D006512:Hepatitis B Core Antigens / Q000235:genetics*; D006515:Hepatitis B virus / Q000235:genetics* / Q000302:isolation & purification / Q000472:pathogenicity*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011401:Promoter Regions, Genetic
chemical_list: D006512:Hepatitis B Core Antigens