title: Profile of pre-S deletions in the natural history of chronic hepatitis B infection.
abstract: It have been suggested that hepatitis B virus (HBV) pre-S deletions may play a role in hepatocarcinogenesis. The aim of the study was to determine the prevalence of pre-S deletions in chronic hepatitis B patients in Hong Kong, the factors associated with the deletions and its relationship with hepatitis B e antigen (HBeAg) seroconversion. HBV pre-S deletions were determined by nucleotide sequence analysis in 178 patients with chronic HBV (cross-sectional study). Eighty-four patients had paired samples before and after HBeAg seroconversion (longitudinal study). The prevalence of pre-S deletions was 12.9% (23/178). A majority of the pre-S deletions (73.9%) occurred in the 5' terminus of pre-S2 region whereas deletions in the pre-S1 region appeared less frequently (47.8%). There was no relationship between age and pre-S deletions. Male gender [odds ratio (OR) =10.88; 95% confidence interval (CI) =1.37-86.52; P=0.024] and HBV genotype C (OR=13.85; 95% CI=3.05-62.92; P=0.001) were independent factors associated with pre-S deletions. Only 17 out of the 84 patients with paired samples before and after HBeAg seroconversion had pre-S deletions. The patterns of pre-S deletions before and after HBeAg seroconversion were variable. Compared with genotype B, HBV genotype C was associated with earlier emergence of pre-S deletions. In conclusion, 12.9% of chronic HBV carriers had pre-S deletions (predominantly pre-S2 deletions) in a geographical area highly endemic for chronic hepatitis B. Male gender and HBV genotype C were associated independently with the development of pre-S deletion mutations. There was no clear relationship between HBeAg seroconversion and pre-S deletions.
authors.affiliation: Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
authors.forename: Pok
authors.initials: P
authors.lastname: Yeung
authors.forename: Danny Ka-Ho
authors.initials: DK
authors.lastname: Wong
authors.forename: Ching-Lung
authors.initials: CL
authors.lastname: Lai
authors.forename: James
authors.initials: J
authors.lastname: Fung
authors.forename: Wai-Kay
authors.initials: WK
authors.lastname: Seto
authors.forename: Man-Fung
authors.initials: MF
authors.lastname: Yuen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D017353:Gene Deletion; D005838:Genotype; D006514:Hepatitis B Surface Antigens / Q000235:genetics*; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000145:classification / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000453:epidemiology* / Q000503:physiopathology* / Q000821:virology; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011498:Protein Precursors / Q000235:genetics*; D012737:Sex Factors; D055815:Young Adult
chemical_list: D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D011498:Protein Precursors; C050806:presurface protein 1, hepatitis B surface antigen; C050807:presurface protein 2, hepatitis B surface antigen