Pre-S deletion and complex mutations of hepatitis B virus related to advanced liver disease in HBeAg-negative patients.

Abstract:

BACKGROUND & AIMS:This longitudinal study investigated the interactions and roles of hepatitis B virus (HBV) genotypes, pre-S deletions, and core promoter and precore mutations on the progression of liver disease in hepatitis B e antigen (HBeAg)-negative patients. METHODS:A total of 141 HBeAg-negative patients without liver cirrhosis or hepatocellular carcinoma at study entry were recruited for this study, including 45 inactive HBV carriers and 96 patients with HBeAg-negative chronic hepatitis B. The HBV genotypes and the sequences of pre-S, core promoter, and precore regions were determined. RESULTS:Compared with patients without developing liver cirrhosis, patients with the development of liver cirrhosis had higher rates of genotype C; pre-S deletions; C or G1753, T1762/A1764, T1766, and/or A1768 mutants; and G1799 variant. Cox regression analysis showed that older age, higher total bilirubin and HBV DNA levels, pre-S deletions, and T1766 and/or A1768 mutants were significantly associated with the development of liver cirrhosis. HBV with a complex mutation pattern (pre-S deletion, T1762/A1764, and T1766 and/or A1768 mutants) rather than a single mutation was associated with the development of liver cirrhosis, and the patterns of mutation combinations differed between HBV genotype B and C. Moreover, pre-S deletion was a significant risk factor for hepatocellular carcinoma. CONCLUSIONS:This study indicated that pre-S deletion and combined mutations of HBV are useful molecular markers for predicting the clinical outcomes of HBeAg-negative patients.

journal_name

Gastroenterology

journal_title

Gastroenterology

authors

Chen CH,Hung CH,Lee CM,Hu TH,Wang JH,Wang JC,Lu SN,Changchien CS

doi

10.1053/j.gastro.2007.09.002

subject

Has Abstract

pub_date

2007-11-01 00:00:00

pages

1466-74

issue

5

eissn

0016-5085

issn

1528-0012

pii

S0016-5085(07)01643-5

journal_volume

133

pub_type

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