Distribution of hepatitis B viral genotypes and mutations in the core promoter and precore regions in acute forms of liver disease in patients from Chiba, Japan
Distribution of hepatitis B viral genotypes and mutations in the core promoter and precore regions in acute forms of liver disease in patients from Chiba, Japan
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DOI：
10.1136/gut.52.11.1630
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发表时间：
2003-11-01
期刊：
影响因子：
24.5
通讯作者：
Saisho, H
中科院分区：
文献类型：
--
作者：
Imamura, T;Yokosuka, O;Saisho, H
背景：慢性肝病(CLD)患者中，不同的HBV型可导致不同的临床特征，但有关其在急性肝病患者中的分布情况的报道较少。方法：对61例急性肝病患者(其中45例为急性自限性肝炎，16例为重型肝炎)和531例慢性肝病患者进行了乙肝病毒基因分型检测，其中包括19例急性加重期患者。我们还分析了增强子II、核心启动子和前C区序列是否存在突变。结果：B型在急性肝病患者中的表达显著高于慢性肝病患者(分别为39.3%和11.7%，p<；0.001)。B型基因在FH患者中的表达显著高于AH患者(62.5%vs31.1%，P=0.027)。前C区A1896突变和核心启动子1753、1754位突变在FH中的发生率高于AH，且B型在FH中占主导地位。结论：HBVB型在急性肝病患者中的发生率高于慢性肝病，且在FH患者中的频率高于AH患者。这些结果表明，至少在来自日本千叶的患者中，这种乙肝病毒基因可能会比其他病毒基因引起更严重的肝脏损害。
Background: Although it has been reported that different hepatitis B virus (HBV) genotypes induce different clinical characteristics in patients with chronic liver diseases (CLD), there have been few reports that have detailed the distribution of HBV genotypes in acute forms of liver disease.Methods: HBV genotypes were determined in 61 patients who had acute forms of liver disease (45 had acute self limited hepatitis (AH) and 16 had fulminant hepatitis (FH)) and in 531 patients with CLD, including 19 patients with severe acute exacerbation of CLD. We also analysed the enhancer II, core promoter, and precore region sequences for the presence of mutations.Results: Expression of genotype B in patients with acute forms of liver disease was significantly greater than in those with CLD (39.3% v 11.7%, respectively; p < 0.001). Furthermore, expression of genotype B was significantly greater in patients with FH than in those with AH (62.5% v 31.1%, respectively; p = 0.027). The precore mutation A1896 and the core promoter mutation at nt 1753 and 1754 were found more frequently in FH than in AH, and genotype B was predominant in FH regardless of the presence of these mutations.Conclusions: HBV genotype B was found more frequently in patients with acute forms of liver disease than in patients with CLD, and more frequently in patients with FH than in those with AH. These results suggest that this HBV genotype may induce more severe liver damage than other viral genotypes, at least in patients from Chiba, Japan.