Clinical Significance of the Genotype and Core Promoter/Pre-Core Mutations in Hepatitis B Virus Carriers

Vol. 49, No. 4, 2006

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Original Paper

Clinical Significance of the Genotype and Core Promoter/Pre-Core Mutations in Hepatitis B Virus Carriers
Satoru Hagiwara^a, Masatoshi Kudo^a, Yasunori Minami^a, Hobyung Chung^a, Tatsuya Nakatani^a, Toyokazu Fukunaga^a, Yukio Osaki^b, Yukitaka Yamashita^c, Kozo Kajimura^d

^aDepartment of Gastroenterology and Hepatology, Kinki University, School of Medicine, Osaka;
^bDepartment of Gastroenterology, Osaka Red Cross Hospital, Osaka;
^cDepartment of Gastroenterology, Japanese Red Cross Society Wakayama Medical Center, Wakayama, and
^dDepartment of Gastroenterology, Kishiwada City Hospital, Osaka, Japan

Address of Corresponding Author

Intervirology 2006;49:200-206 (DOI: 10.1159/000090789)

Key Words

Hepatitis B virus
Genotype
Core promoter
Pre-core

Abstract

It has been shown that clinical and virological characteristics vary among hepatitis B virus (HBV) genotypes. In this study, we measured the virus level, disease severity, and presence or absence of core promoter (CP)/pre-core (PC) mutations in 241 HBV carriers, and investigated the clinical significance of measuring the HBV genotype. In genotype C HBV carriers, the proportion of hepatitis B e antigen (HBeAg)-positive patients was significantly higher than that in genotype B HBV carriers (0 vs. 34.4%, p < 0.05), and the virus level was higher (4.9 vs. 4.05 LGE/ml). In the genotype B HBV carriers, the incidence of PC mutation was significantly higher (69 vs. 34%, p < 0.05). In the genotype C HBV carriers, the incidence of CP mutation was significantly higher (13 vs. 78%, p < 0.05). We compared patients with the wild (W)/mutant (M) pattern in the CP/PC regions to those with the M/W pattern in the CP/PC regions among the genotype C HBV carriers. Both the proportion of HBeAg-positive patients (65.8 vs. 15.4%, p < 0.05) and the alanine aminotransferase (ALT) level (48 vs. 21.5 IU, p < 0.05) were higher in the patients with the M/W pattern in the CP/PC regions, and the disease severity was deteriorated. In conclusion, genotype B HBV may more frequently induce HBe seroconversion via PC mutation compared to genotype C HBV. Among the genotype C HBV carriers, hepatitis activity and the deterioration of the disease severity were significantly inhibited in the group in which PC mutation initially occurred, in comparison to the group in which CP mutation initially occurred.

Author Contacts

Masatoshi Kudo, MD, PhD
Department of Gastroenterology and Hepatology
Kinki University, School of Medicine, 377-2 Ohno-Higashi
Osaka-Sayama, Osaka 589-8511 (Japan)
Tel. +81 722 366 0221, Fax +81 722 367 2880, E-Mail m-kudo@med.kindai.ac.jp

Article Information

Received: June 13, 2005
Accepted: June 20, 2005
Published online: January 11, 2006
Number of Print Pages : 7
Number of Figures : 5, Number of Tables : 3, Number of References : 33

Medline Abstract (ID 16407657)

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