title: Hepatitis B virus preS1 deletion is related to viral replication increase and disease progression.
abstract: OBJECTIVE
  To investigate the clinical implications of hepatitis B virus (HBV) preS1 deletion.
  
  
  METHODS
  We developed a fluorescence resonance energy transfer-based real-time polymerase chain reaction (RT-PCR) that can detect four genotypes (wild type, 15-bp, 18-bp and 21-bp deletion). The PCR method was used in two cohorts of Korean chronic HBV subjects with genotype C infections. Cohort I included 292 chronic HBV subjects randomly selected from Cheju National University Hospital (Jeju, South Korea) or Seoul National University Hospital (Seoul, South Korea), and cohort II included 90 consecutive chronic HBV carriers recruited from Konkuk University Hospital (Seoul, South Korea); the cohort II patients did not have hepatocellular carcinoma or liver cirrhosis.
  
  
  RESULTS
  The method proposed in this study identified 341 of 382 samples (89.3%). Deletion variants were identified in 100 (29.3%) of the 341 detected samples. In both cohorts, the subjects with deletions had a significantly higher Hepatitis B virus e antigen (HBeAg)-positive seroprevalence [cohort I, wild (51.0%) vs deletion (75.0%), P < 0.001; cohort II, wild (69.2%) vs deletion (92.9%), P = 0.002] and higher HBV DNA levels [cohort I, wild (797.7 pg/mL) vs deletion (1678.9 pg/mL), P = 0.013; cohort II, wild (8.3 × 10(8) copies/mL) vs deletion (2.2 × 10(9) copies/mL), P = 0.049], compared to subjects with wild type HBV.
  
  
  CONCLUSIONS
  HBV genotype C preS1 deletion may affect disease progression in chronic HBV subjects through an extended duration of HBeAg seropositive status and increased HBV replications.
authors.affiliation: Seoung-Ae Lee, Hong Kim, You-Sub Won, Bum-Joon Kim, Department of Biomedical Sciences, Microbiology and Immunology, and Liver Research Institute, Seoul National University College of Medicine, Seoul 110-799, South Korea.
authors.forename: Seoung-Ae
authors.initials: SA
authors.lastname: Lee
authors.affiliation: Seoung-Ae Lee, Hong Kim, You-Sub Won, Bum-Joon Kim, Department of Biomedical Sciences, Microbiology and Immunology, and Liver Research Institute, Seoul National University College of Medicine, Seoul 110-799, South Korea.
authors.forename: Ki-Jeong
authors.initials: KJ
authors.lastname: Kim
authors.affiliation: Seoung-Ae Lee, Hong Kim, You-Sub Won, Bum-Joon Kim, Department of Biomedical Sciences, Microbiology and Immunology, and Liver Research Institute, Seoul National University College of Medicine, Seoul 110-799, South Korea.
authors.forename: Hong
authors.initials: H
authors.lastname: Kim
authors.affiliation: Seoung-Ae Lee, Hong Kim, You-Sub Won, Bum-Joon Kim, Department of Biomedical Sciences, Microbiology and Immunology, and Liver Research Institute, Seoul National University College of Medicine, Seoul 110-799, South Korea.
authors.forename: Won-Hyuk
authors.initials: WH
authors.lastname: Choi
authors.affiliation: Seoung-Ae Lee, Hong Kim, You-Sub Won, Bum-Joon Kim, Department of Biomedical Sciences, Microbiology and Immunology, and Liver Research Institute, Seoul National University College of Medicine, Seoul 110-799, South Korea.
authors.forename: Yu-Sub
authors.initials: YS
authors.lastname: Won
authors.affiliation: Seoung-Ae Lee, Hong Kim, You-Sub Won, Bum-Joon Kim, Department of Biomedical Sciences, Microbiology and Immunology, and Liver Research Institute, Seoul National University College of Medicine, Seoul 110-799, South Korea.
authors.forename: Bum-Joon
authors.initials: BJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D018387:Codon, Initiator; D004279:DNA, Viral / Q000097:blood / Q000235:genetics*; D018450:Disease Progression; D005260:Female; D031541:Fluorescence Resonance Energy Transfer; D017353:Gene Deletion; D005838:Genotype; D006514:Hepatitis B Surface Antigens / Q000235:genetics*; D006515:Hepatitis B virus / Q000235:genetics* / Q000472:pathogenicity; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology*; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D011498:Protein Precursors / Q000235:genetics*; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D014779:Virus Replication / Q000235:genetics*
chemical_list: D018387:Codon, Initiator; D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D011498:Protein Precursors; C050806:presurface protein 1, hepatitis B surface antigen
keywords: Genotype C; Hepatitis B virus; Hepatitis B virus e antigen; Hepatocellular carcinoma; PreS1 start codon deletion