Clinical Significance of Hepatitis B Virus Precore and Core Promoter Variants in Korean Patients With Chronic Hepatitis B
- Yim, Sun Young; Um, Soon Ho; Jung, Jin Young; Kim, Tae Hyung; Kim, Jin Dong; Keum, Bora; Seo, Yeon Seok; Yim, Hyung Joon; Jeen, Yoon Tae; Lee, Hong Sik; Chun, Hoon Jai; Kim, Chang Duck; Ryu, Ho Sang
- Issue Date
- LIPPINCOTT WILLIAMS & WILKINS
- chronic hepatitis B; precore variant; core promoter variants; hepatitis B virus; hepatitis B e antigen
- JOURNAL OF CLINICAL GASTROENTEROLOGY, v.49, no.1, pp.61 - 68
- Journal Title
- JOURNAL OF CLINICAL GASTROENTEROLOGY
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- Background/Aim: We aimed to clarify the clinical significance of precore (preC)/core promoter (CP) variants of hepatitis B virus (HBV) in chronic hepatitis B (CHB) patients. Methods: We assessed serum HBeAg, HBV DNA levels, alanine transferase (ALT) levels, and progression of liver fibrosis in 226 Korean CHB patients, presumed to be infected with genotype C HBV, to analyze HBV variants in the preC region (G1896A) and CP regions (A1762T, G1764A). Results: CP and preC variants were more frequently found in HBeAg-negative patients than in HBeAg-positive patients (P < 0.05). HBeAg-positive patients with CP variants had higher ALT levels and more advanced fibrosis scores (all P < 0.01) than those without variants; those with preC variant had lower HBV DNA levels (P = 0.009), with no significant difference in ALT levels and fibrosis scores. However, no significant correlation was found between HBV variants and clinicopathologic findings in HBeAg-negative patients. Furthermore, multivariate analysis revealed that (1) progression of liver fibrosis (>= F2) was associated with older age in both HBeAg-positive and HBeAg-negative patients (P < 0.05) and with CP variants in the HBeAg-positive group (P = 0.007), and (2) HBV DNA levels were positively correlated with ALT levels, irrespective of HBeAg (P < 0.05), whereas they were negatively correlated with the presence of preC variant in the HBeAg-positive group (P = 0.004). Conclusions: In HBeAg-positive CHB patients infected with genotype C HBV, preC variant was associated with enhanced host immune response with lower HBV DNA levels, whereas CP variants were associated with severe liver damage and liver fibrosis progression.
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- 2. Clinical Science > Department of Internal Medicine > 1. Journal Articles
- 5. Others > Others(Medicine) > 1. Journal Articles
- 2. Clinical Science > Department of Gastroenterology and Hepatology > 1. Journal Articles
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