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Novel application of a point mutation assay: evidence for transmission of hepatitis B viruses with precore mutations and their detection in infants with fulminant hepatitis B.

Abstract：

:Mutations of the precore region of hepatitis B virus (HBV) genome have been associated with fulminant and severe chronic hepatitis. However uncertainty remains about the clinical significance and transmissibility of these mutant strains. A point mutation assay (PMA) was developed to identify qualitatively and quantitatively mutations affecting precore amino acids 1 and 28. We have analysed serum samples from six mother-infant pairs where perinatal transmission of HBV has occurred and where the mothers were HBV carriers without detectable serum HBeAg. In three cases fulminant hepatitis developed in the infant, in two cases acute hepatitis resolved, and in one case the infant was immunised and did not become infected. We also examined serum from a healthcare worker, an anti-HBe-seropositive HBV carrier, believed to have transmitted HBV infection to a patient. The PMA results were confirmed in all cases by direct sequencing of polymerase chain reaction (PCR) products using nested and double-nested PCR with primers to the precore and X region. Precore aa28 mutant-type virus was detected in the serum of one mother at the time of delivery of three of her children, two of whom developed fulminant hepatitis. Another mother of an infant with fulminant hepatitis had no precore mutations. In one mother-infant pair a mixed viral population was found; the acute hepatitis B in the infant resolved. The HBV sequence from the healthcare worker was also of aa28 mutant type. No mutations of aa1 were detected in any of the specimens. The study supports the association of precore mutations with some cases of transmission of HBV infection from HBeAg-negative mothers to their infants.(ABSTRACT TRUNCATED AT 250 WORDS)

journal_name

J Med Virol

journal_title

Journal of medical virology

authors

Hawkins AE,Gilson RJ,Beath SV,Boxall EH,Kelly DA,Tedder RS,Weller IV

doi

10.1002/jmv.1890440105

subject

Has Abstract

pub_date

1994-09-01 00:00:00

pages

13-21

issue

eissn

0146-6615

issn

1096-9071

journal_volume

pub_type

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Novel application of a point mutation assay: evidence for transmission of hepatitis B viruses with precore mutations and their detection in infants with fulminant hepatitis B.