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Virology

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

Chien-Hung Chen, Chuan-Mo Lee, Sheng-Nan Lu, Chi-Sin Changchien, Hock-Liew Eng, Chao-Min Huang, Jing-Houng Wang, Chao-Hung Hung, Tsung-Hui Hu
Chien-Hung Chen
1Division of Hepatogastroenterology
2Department of Internal Medicine, Graduate Institute of Clinical Medical Sciences
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Chuan-Mo Lee
1Division of Hepatogastroenterology
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  • For correspondence: chmolee@ms15.hinet.net
Sheng-Nan Lu
1Division of Hepatogastroenterology
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Chi-Sin Changchien
1Division of Hepatogastroenterology
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Hock-Liew Eng
3Chang Gung University, Department of Pathology, Kaohsiung Chang Gung Memorial Hospital, 123 Ta Pei Road, Kaohsiung, Taiwan
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Chao-Min Huang
1Division of Hepatogastroenterology
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Jing-Houng Wang
1Division of Hepatogastroenterology
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Chao-Hung Hung
1Division of Hepatogastroenterology
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Tsung-Hui Hu
1Division of Hepatogastroenterology
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DOI: 10.1128/JCM.43.12.6000-6006.2005
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    FIG. 1.

    Prevalence of T1762 and A1764 core promoter mutations in 200 genotype B and genotype C hepatitis B virus-infected patients with various liver diseases.

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  • TABLE 1.

    Clinical features, HBV viremia, and prevalence of mutations in precore and core promoter regions in different clinical stages of chronic hepatitis B patients

    CharacteristicAsympatomatic carriers (n = 66)Chronic hepatitis patients (n = 95)Liver cirrhosis patients (n = 39)P value
    Age (yr)31.7 ± 10.236.5 ± 11.345.3 ± 11.9<0.001
    Sex (no. of males:no. of females)35:3176:1933:6<0.005
    ALT level (U/liter)23.8 ± 9.8186.6 ± 187.1122.8 ± 126.8NSa
    HBV DNA concn (log pg/ml)2.4 ± 1.11.6 ± 1.10.001
    HAI inflammation score6.1 ± 3.66.4 ± 3.4NS
    No. (%) of patients infected with HBV:
        Genotype B526514<0.001
        Genotype C14 (21.1)27 (29.3)25 (64.1)
        T or G175228 (42.4)35 (36.8)8 (20.5)<0.05
        C175303 (3.2)7 (17.9)<0.001
        T1762/A176411 (16.7)32 (33.7)34 (87.2)<0.001
        T1766/A17681 (1.5)7 (7.4)6 (15.4)<0.01
        T17738 (12.1)4 (4.2)1 (2.6)<0.05
        C179948 (72.7)67 (70.5)15 (38.5)<0.005
        T184614 (21.2)17 (17.9)12 (30.8)NS
        C18587 (10.6)2 (2.1)1 (2.6)<0.05
        A189613 (19.7)34 (35.8)19 (48.7)<0.005
        A18995 (7.5)1 (1.1)4 (10.3)NS
    • ↵ a NS, not significant.

  • TABLE 2.

    Clinical features, HBV genotypes, HBV DNA levels, and liver inflammation in relation to HBeAg and clinical status

    HBeAg and clinical statusNo. of patientsAge (yr)Sex (no. of males:no. of females)No. infected with genotype B:no. infected with genotype CALT level (U/liter)HBV DNA concn (log pg/ml)HAI inflammation scoreHAI fibrosis score
    HBeAg positive
        Asymptomatic carriers2831.6 ± 8.913:1520:825.3 ± 13.2
        Chronic hepatitis patients5934 ± 10.0a45:1437:19201.9 ± 169.52.8 ± 1.0c6.4 ± 3.70.8 ± 1.1
        Liver cirrhosis patients1644.4 ± 1215:14:1287.5 ± 58.62.0 ± 1.2d6.4 ± 4.54
            Subtotal10335 ± 10.8b73:3061:39136.1 ± 152.12.6 ± 1.1e6.4 ± 3.81.5 ± 1.6f
    HBeAg negative
        Asymptomatic carriers3831.7 ± 11.322:1632:622.8 ± 9.9
        Chronic hepatitis patients3640.5 ± 12.1a31:528:8161.5 ± 212.91.7 ± 1.0c5.6 ± 3.40.9 ± 1.2
        Liver cirrhosis patients2345.8 ± 1218:510:13147.4 ± 154.61.3 ± 1.0d6.4 ± 2.54
            Subtotal9738.4 ± 12.9b71:2670:27103.8 ± 162.31.5 ± 1.0e5.9 ± 3.12.1 ± 1.8f
    • ↵ a P = 0.0056.

    • ↵ b P < 0.001.

    • ↵ c P < 0.001.

    • ↵ d P = 0.057.

    • ↵ e P < 0.001.

    • ↵ f P = 0.044.

  • TABLE 3.

    HBV precore and core promoter mutations in relation to HBeAg and clinical status

    HBeAg and clinical statusNo. (%) of patients
    TotalT or G1752C1753T1762/ A1764T1766/A1768T1773C1799T1846C1858A1896A1899
    HBeAg positive
        Asymptomatic carriers2814 (50)02 (7.1)01 (3.6)20 (71.4)1 (3.6)g1 (3.6)1 (3.6)0
        Chronic hepatitis patients5924 (40.7)1 (1.7)17 (28.8)2 (3.4)2 (3.4)41 (69.5)7 (11.9)2 (3.4)11 (18.6)0
        Liver cirrhosis patients162 (12.5)1 (6.2)14 (87.5)3 (18.7)05 (31.3)1 (6.2)h1 (6.3)3 (18.7)0
            Subtotal10340 (38.8)2 (1.9)a33 (32)b5 (4.9)3 (2.9)c66 (64.1)9 (8.8)d4 (3.9)15 (14.6)e0f
    HBeAg negative
        Asymptomatic carriers3814 (36.8)09 (23.7)1 (2.6)7 (18.4)28 (73.7)13 (34.2)g6 (15.8)12 (31.5)5 (13.2)
        Chronic hepatitis patients3611 (30.5)2 (5.5)15 (41.6)5 (13.9)2 (5.5)26 (72.2)10 (27.8)023 (63.8)1 (2.8)
        Liver cirrhosis patients236 (26.1)6 (26.1)20 (86.9)3 (13)1 (4.3)10 (43.5)11 (47.8)h016 (69.6)4 (17.4)
            Subtotal9731 (31.9)8 (8.2)a44 (45.4)b9 (9.3)10 (10.3)c64 (66)34 (35.1)d6 (6.2)50 (51.5)e10 (10.3)f
    • ↵ a P = 0.05.

    • ↵ b P = 0.06.

    • ↵ c P = 0.044.

    • ↵ d P < 0.001.

    • ↵ e P < 0.001.

    • ↵ f P = 0.001.

    • ↵ g P = 0.004.

    • ↵ h P = 0.012.

  • TABLE 4.

    Association of predictive factors with the risk of liver cirrhosis in patients with chronic hepatitis B virus infection

    FactorOR (95% CI)
    Total (n = 200)HBeAg positive (n = 103)HBeAg negative (n = 97)
    Age ≥35 vs <35 yr3.42 (1.33-8.77)4.42 (1.03-19.0)
    Genotype C vs genotype B infection2.87 (1.21-6.81)4.01 (1.3-12.37)
    Presence vs absence of T1762 and A1764 mutant11.11 (3.91-31.25)16.95 (3.4-83.33)11.36 (2.99-43.48)
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Clinical Significance of Hepatitis B Virus (HBV) Genotypes and Precore and Core Promoter Mutations Affecting HBV e Antigen Expression in Taiwan
Chien-Hung Chen, Chuan-Mo Lee, Sheng-Nan Lu, Chi-Sin Changchien, Hock-Liew Eng, Chao-Min Huang, Jing-Houng Wang, Chao-Hung Hung, Tsung-Hui Hu
Journal of Clinical Microbiology Dec 2005, 43 (12) 6000-6006; DOI: 10.1128/JCM.43.12.6000-6006.2005

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Clinical Significance of Hepatitis B Virus (HBV) Genotypes and Precore and Core Promoter Mutations Affecting HBV e Antigen Expression in Taiwan
Chien-Hung Chen, Chuan-Mo Lee, Sheng-Nan Lu, Chi-Sin Changchien, Hock-Liew Eng, Chao-Min Huang, Jing-Houng Wang, Chao-Hung Hung, Tsung-Hui Hu
Journal of Clinical Microbiology Dec 2005, 43 (12) 6000-6006; DOI: 10.1128/JCM.43.12.6000-6006.2005
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KEYWORDS

Hepatitis B Core Antigens
Hepatitis B e Antigens
hepatitis B virus
mutation
Promoter Regions, Genetic
Protein Precursors

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