Clinical significance of Hepatitis B Virus precore and core promoter variants in Korean patients with chronic hepatitis b

Sun Young Yim, Soon Ho Um, Jin Young Jung, Tae Hyung Kim, Jin Dong Kim, Bora Keum, Yeon Seok Seo, Hyung Joon Yim, Yoon Tae Jeen, Hong Sik Lee, Hoon Jai Chun, Chang Duck Kim, Ho Sang Ryu

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)61-68
Number of pages8
JournalJournal of Clinical Gastroenterology
Volume49
Issue number1
DOIs
Publication statusPublished - 2015 Jan

Keywords

  • Chronic hepatitis B
  • Core promoter variants
  • Hepatitis B e antigen
  • Hepatitis B virus
  • Precore variant

ASJC Scopus subject areas

  • Gastroenterology

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