期刊
CLINICAL MICROBIOLOGY AND INFECTION
卷 18, 期 10, 页码 E412-E418出版社
ELSEVIER SCI LTD
DOI: 10.1111/j.1469-0691.2012.03975.x
关键词
e-negative' hepatitis B; genotype D; HBV; Hepatitis B e-antigen (HBeAg)-negative chronic infection; inactive carrier; liver cirrhosis; mutations
资金
- Indian Council of Medical Research [5/8/7/5/2008/ECD-I]
Clin Microbiol Infect 2012; 18: E412E418 Abstract Hepatitis B e-antigen (HBeAg)-negative chronic HBV infection is highly prevalent in several parts of the world, including India, with the clinical spectrum ranging from inactive carrier (IC) state to chronic e-negative hepatitis B (CHB) and culminating in advanced liver disease such as cirrhosis (LC). The present study has for the first time investigated the natural diversity of HBV belonging to genotype D in treatment-naive Indian patients representing the above phases of HBeAg-negative infection to identify candidate mutations associated with each disease state. Studies of full-length HBV/D sequences revealed that the progressive accumulation and persistence of mutations in basal core promoter, negative regulatory element, Pre-core region, the B- and T-cell epitopes of X protein as well as deletions in the PreS region contribute significantly to disease progression from IC through CHB to LC. In addition, the development of CHB was associated with a significant increase in viral variants characterized by mutations in enhancer II, preS1 promoter, T-cell epitope of core and B-cell epitope region of PreS1. While few of the mutations were previously reported in the context of HBV genotypes B and C, others had not been documented before. Our results thus highlight a distinct pattern of mutation in HBV/D that may help in predicting clinical outcomes of HBeAg-negative infection and have implications for better clinical management of the patients.
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