Clinical Significance of Hepatitis B Virus Precore and Core Promoter Variants in Korean Patients With Chronic Hepatitis B. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Yim, Sun Young; Um, Soon Ho; Young Jung, Jin; 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
• Is Part Of: Journal of clinical gastroenterology. Volume 49:Issue 1(2015)
• Publication Date: 2015-01
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Digestive organs -- Diseases; Gastroenterology; Periodicals; Periodicals; 616.33005
• DOI: 10.1097/MCG.0000000000000052
• Languages: English
• ISSNs: 0192-0790

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Background/Aim:</title> <p>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.</p> </sec> <sec> <title>Methods:</title> <p>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).</p> </sec> <sec> <title>Results:</title> <p>CP and preC variants were more frequently found in HBeAg-negative patients than in HBeAg-positive patients (<italic>P</italic><0.05). HBeAg-positive patients with CP variants had higher ALT levels and more advanced fibrosis scores (all <italic>P</italic><0.01) than those without variants; those with preC variant had lower HBV DNA levels (<italic>P</italic>=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 (<italic>P<</italic>0.05) and with CP variants in the HBeAg-positive group (<italic>P</italic>=0.007), and (2) HBV DNA levels were positively correlated with ALT levels, irrespective of HBeAg (<italic>P</italic><0.05), whereas they were negatively correlated with the presence of preC variant in the HBeAg-positive group (<italic>P</italic>=0.004).</p> </sec> <sec> <title>Conclusions:</title> <p>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.</p> </sec> </abstract>