title: Associations between hepatitis B virus basal core promoter/pre-core region mutations and the risk of acute-on-chronic liver failure: a meta-analysis.
abstract: BACKGROUND
  Several studies have suggested a relationship between hepatitis B virus (HBV) basal core promoter/pre-core mutations and HBV-induced acute-on-chronic liver failure (ACLF). Therefore, we evaluated this potential relationship using a meta-analysis.
  
  
  METHODS
  Chinese or English studies from 1966 to January 31, 2014 were included in the analysis. A random or fixed-effects model was used to merge the odds ratios (ORs).
  
  
  RESULTS
  We identified 31 case-control studies containing a total population of 1995 ACLF and 3822 chronic hepatitis B (CHB) patients. Several mutations were significantly correlated with ACLF: T1753V (1.889, 95 % confidence interval (CI) [1.357-2.631]), A1762T (2.696 [2.265-3.207]), G1764A (3.005 [2.077-4.347]), A1762T/G1764A (2.379 [1.519-3.727]), C1766T (1.849 [1.403-2.437]), T1768A (2.440 [1.405-3.494]), A1846T (3.163 [2.157-4.639]), G1896A (2.181 [1.800-2.642]), G1899A (3.569 [2.906-4.385]) and G1896A/A1762T/G1764A (1.575 [1.172-2.116]). Additionally, HBeAg-negative status was also statistically significant for the progression to ACLF (OR = 2.813, 95 % CI = 2.240-3.533, p < 0.001). However, there was no association between ACLF development and HBV genotype.
  
  
  CONCLUSIONS
  The HBV basal core promoter/pre-core mutations T1753V, A1762T, G1764A, C1766T, T1768A, A1846T, G1896A and G1899A, and an HBeAg-negative status correlate with an increased risk of HBV-ACLF.
authors.affiliation: State Key Lab of Diagnostic and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital of Medical School, Zhejiang University, Hangzhou, 310000, China. 06yxsyhfs@163.com.
authors.forename: Feishu
authors.initials: F
authors.lastname: Hu
authors.affiliation: State Key Lab of Diagnostic and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital of Medical School, Zhejiang University, Hangzhou, 310000, China. 372640052@qq.com.
authors.forename: Sheng
authors.initials: S
authors.lastname: Bi
authors.affiliation: Department of Hepatology, Ningbo No. 2 Hospital, Ningbo, 315010, China. jifangsheng9200@163.com.
authors.forename: Huadong
authors.initials: H
authors.lastname: Yan
authors.affiliation: State Key Lab of Diagnostic and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital of Medical School, Zhejiang University, Hangzhou, 310000, China. zjushiyu@zju.edu.cn.
authors.forename: Yu
authors.initials: Y
authors.lastname: Shi
authors.affiliation: State Key Lab of Diagnostic and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital of Medical School, Zhejiang University, Hangzhou, 310000, China. shengji.fang@163.com.
authors.forename: Jifang
authors.initials: J
authors.lastname: Sheng
mesh_terms: D065290:Acute-On-Chronic Liver Failure / Q000453:epidemiology* / Q000821:virology*; D000328:Adult; D005260:Female; D006513:Hepatitis B e Antigens / Q000235:genetics*; D006515:Hepatitis B virus / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009154:Mutation; D011401:Promoter Regions, Genetic; D018570:Risk Assessment; D055815:Young Adult
chemical_list: D006513:Hepatitis B e Antigens