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Influence of genotypes and precore mutations on fulminant or chronic outcome of acute hepatitis B virus infection.

Influence of genotypes and precore mutations on fulminant or chronic outcome of acute hepatitis B virus infection.

Authors :
Ozasa A
Tanaka Y
Orito E
Sugiyama M
Kang JH
Hige S
Kuramitsu T
Suzuki K
Tanaka E
Okada S
Tokita H
Asahina Y
Inoue K
Kakumu S
Okanoue T
Murawaki Y
Hino K
Onji M
Yatsuhashi H
Sakugawa H
Miyakawa Y
Ueda R
Mizokami M
Source :
Hepatology (Baltimore, Md.) [Hepatology] 2006 Aug; Vol. 44 (2), pp. 326-34.
Publication Year :
2006

Abstract

The outcome of acute hepatitis B virus (HBV) infection is variable, influenced by host and viral factors. From 1982 through 2004, 301 patients with acute HBV infection entered a multi-center cross-sectional study in Japan. Patients with fulminant hepatitis (n = 40) were older (44.7 +/- 16.3 vs. 36.0 +/- 14.3 years, P < .0017), less predominantly male (43% vs. 71%, P = .0005), less positive for hepatitis B e antigen (HBeAg) (23% vs. 60%, P < .0001), less infected with subgenotype Ae (0% vs. 13%, P < .05), and more frequently with Bj (30% vs. 4%, P < .0001) than those with acute self-limited hepatitis (n = 261). Precore (G1896A) and core-promoter (A1762T/G1764A) mutations were more frequent in patients with fulminant than acute self-limited hepatitis (53% vs. 9% and 50% vs. 17%, P < .0001 for both). HBV infection persisted in only three (1%) patients, and they represented 2 of the 23 infected with Ae and 1 of the 187 with the other subgenotypes (9% vs. 0.5%, P = .032); none of them received antiviral therapy. In multivariate analysis, age 34 years or older, Bj, HBeAg-negative, total bilirubin 10.0 mg/dL or greater, and G1896A mutation were independently associated with the fulminant outcome. In in vitro transfection experiments, the replication of Bj clone was markedly enhanced by introducing either G1896A or A1762T/G1764A mutation. In conclusion, persistence of HBV was rare (1%) and associated with Ae, whereas fulminant hepatitis was frequent (13%) and associated with Bj and lack of HBeAg as well as high replication due to precore mutation in patients with acute HBV infection.

Details

Language :
English
ISSN :
0270-9139
Volume :
44
Issue :
2
Database :
MEDLINE
Journal :
Hepatology (Baltimore, Md.)
Publication Type :
Academic Journal
Accession number :
16871568
Full Text :
https://doi.org/10.1002/hep.21249