Search

Mutations of precore (A1896) and core promoter (T1762/A1764) of hepatitis B virus can reduce HBeAg production. These mutations are frequently found in the late HBeAg seroconversion. However, it has been a controversy about the role played by precore and core promoter mutations in determining outcome of chronic hepatitis B. In the present study, the variability of precore and core promoter of hepatitis B virus were analyzed using PCR amplification and sequencing, according to the outcome (viral load and HBeAg/anti-HBe) in chronic hepatitis B patients in Surabaya. The study groups included 5 patients with uncomplicated chronic hepatitis B and 10 patients with chronic hepatitis B and liver cirrhosis in Dr. Soetomo Hospital, Surabaya. The control group included 6 blood donors obtained from Indonesia Red Cross, Surabaya. All groups were HBsAg positive. Precore mutation A1896 was predominant in all groups (60%-67% of each), together with precore variant T1858. As reported, precore variant T1858 is a prerequisite for precore A1896 and characteristic for viral genotype. Nevertheless, core promoter mutations T1762/A1764 were predominant only in LC patients (60%). All of these mutations were found mostly after HBeAg seroconversion (anti-HBe+). Of most samples with anti-HBe+, precore mutation was related with low viral load (105 copies/mL). Precore mutation A1896 was predominant in all groups, but core promoter mutations T1762/A1764 were only predominant in LC patients. The precore mutation alone is possible not critical to indicate a poor outcome, the core promoter mutations must be considered also.

The prevalence of hepatitis C virus (HCV) infection has been as high as approximately 80% in patients with maintenance hemodialysis in public hospitals in Indonesia. However, the prevalence in private hospitals has not been examined yet. The aim of this study was to investigate the prevalence of anti-HCV antibody and the subtype distribution in patients with hemodialysis in a private hospital in Surabaya, Indonesia. Sera were obtained from 41 hemodialysis patients in a private hospital in Surabaya. The positive prevalence of anti-HCV antibody was carried out by the enzyme-linked immunosorbent assay (ELISA). Anti-HCV-positive sera were subjected to reverse transcription-PCR (RT-PCR) to detect HCV RNA and then direct sequencing. The HCV subtype was examined by phylogenetic analysis. Twenty five patients (61%) out of 41 were positive for anti-HCV antibody, and HCV-RNA was detected in 19 patients. The positive prevalence of anti-HCV antibody was 7.7% (one out of 13 patients) among patients who had undergone hemodialysis for less than one year, whereas it was 85.7% (24 out of 28 patients) among patients who had undergone hemodialysis for over one year. Phylogenetic analysis revealed HCV-1a (52.6%) was the most common subtype, followed by 1b (15.8%), 1c (15.8%), 2a (5.3%), and 3k (5.3%). In conclusion, the prevalence of HCV infection among hemodialysis patients in a private hospital was as high as that in general hospitals. The predominant subtype was HCV-1a, which is in accordance with the previous studies in general hospitals in Surabaya, Indonesia.