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Journal of Clinical Microbiology, December 2005, p. 6000-6006, Vol. 43, No. 12
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.12.6000-6006.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Clinical Significance of Hepatitis B Virus (HBV) Genotypes and Precore and Core Promoter Mutations Affecting HBV e Antigen Expression in Taiwan

Chien-Hung Chen,1,2 Chuan-Mo Lee,1* Sheng-Nan Lu,1 Chi-Sin Changchien,1 Hock-Liew Eng,3 Chao-Min Huang,1 Jing-Houng Wang,1 Chao-Hung Hung,1 and Tsung-Hui Hu1

Division of Hepatogastroenterology,1 Department of Internal Medicine, Graduate Institute of Clinical Medical Sciences,2 Chang Gung University, Department of Pathology, Kaohsiung Chang Gung Memorial Hospital, 123 Ta Pei Road, Kaohsiung, Taiwan3

Received 14 May 2005/ Returned for modification 12 August 2005/ Accepted 16 September 2005

To assess the prevalence and clinical significance of hepatitis B virus (HBV) genotypes and precore and core promoter mutations in Taiwan, a cohort of 200 Taiwanese chronic hepatitis B patients was analyzed. The HBV genotypes and sequences of the precore and the core promoter regions were determined in 66 asymptomatic carriers and 134 patients who had liver biopsy-verified chronic hepatitis and liver cirrhosis. The HBV e-antigen (HBeAg)-negative patients had a higher frequency of mutations at core promoter nucleotides 1753 and 1773 and precore nucleotides 1846, 1896, and 1899 than HBeAg-positive patients. Among the 200 patients, the frequencies of genotype C, T1762 and A1764, C1753, T1766 and A1768, and A1896 mutations increased and the frequencies of T or G1752, T1773, G1799, and C1858 mutations decreased with advancing liver diseases. These factors were different between those with HBeAg-positive status and those with HBeAg-negative status. Based on multiple logistic regression analysis, the risk factors of liver cirrhosis for 200 patients were the presence of T1762 and A1764 mutations (odds ratio [OR] = 11.11; 95% confidence interval [CI] = 3.91 to 31.25; P < 0.001), age ≥35 years (OR = 3.42; 95% CI = 1.33 to 8.77; P = 0.011), and genotype C (OR = 2.87; 95% CI = 1.21 to 6.81; P = 0.017). Further categorical analysis found that 62.1% of patients with genotype C, T1762 and A1764 mutations and age ≥35 years had liver cirrhosis. None of the 55 patients infected with the genotype B, A1762 and G1764 wild type and age <35 years showed liver cirrhosis. In conclusion, our data suggest that pathogenic differences between HBeAg-positive and -negative patients may exist. In Taiwan, HBV genotype C and the T1762 and A1764 mutations may play a role in HBV-related liver cirrhosis, and these could serve as molecular markers for prediction of the clinical outcomes of chronic HBV patients.

* Corresponding author. Mailing address: Division of Hepatogastroenterology, Department of Internal Medicine, Kaoshiung Chang Gung Memorial Hospital, 123 Ta Pei Road, Kaohsiung, Taiwan. Phone: 886-7-731-7123. Fax: 886-7-731-8762. E-mail: chmolee{at}ms15.hinet.net.

Journal of Clinical Microbiology, December 2005, p. 6000-6006, Vol. 43, No. 12
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.12.6000-6006.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



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