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Low level wild‐type and pre‐core mutant hepatitis B viruses and hbeAg negative reactivation of chronic hepatitis B
Author(s) -
Oketani Makoto,
Oketani Kaoru,
Xiaohong Cui,
Arima Terukatsu
Publication year - 1999
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/(sici)1096-9071(199908)58:4<332::aid-jmv3>3.0.co;2-q
Subject(s) - hepatitis b virus , virology , hbeag , hepatitis b , group b , mutant , group a , hepadnaviridae , biology , orthohepadnavirus , polymerase chain reaction , hepatitis b virus dna polymerase , microbiology and biotechnology , medicine , virus , hbsag , gene , genetics
A qualitative and a quantitative mutation‐site specific polymerase chain reaction assay (MSSA) was used to detect low level wild‐type and pre‐core mutant hepatitis B virus (HBV)‐DNA. Serum samples from 11 anti‐hepatitis B e (anti‐HBe)‐positive asymptomatic HBV carriers (Group A) and 10 anti‐HBe‐positive chronic hepatitis B patients who achieved alanine transaminase (ALT) normalization after antiviral therapy (Group B) were tested. Eleven patients had both wild‐type and pre‐core mutant HBV‐DNA (52%, 4 from Group A and 7 from Group B), whereas 3 patients had only pre‐core mutant HBV‐DNA (14%, 2 from Group A and 1 from Group B) by qualitative MSSA assay. During a 3‐year follow‐up period, relapses were observed in 3 patients from Group B and intermittent ALT elevation was observed in 4 patients from Group A and 3 patients from Group B. The wild‐type HBV‐DNA concentration in the patients with reactivation was 10 2.06±2.62 copies/ml, whereas that in all patients without reactivation was below 10 2 copies/ml ( P < .05). The pre‐core mutant HBV‐DNA concentration in the patients with reactivation was also significantly higher than that in the patients without reactivation (10 3.94±2.25 vs. 10 0.65±1.45 copies/ml, P < .001). All patients with both HBV‐DNA concentrations below 10 2 copies/ml did not exhibit reactivation. Our result suggest that a high prevalence of coexistence of low level wild‐type and pre‐core mutant HBV‐DNA has the potential for reactivation in anti‐HBe‐positive patients. Furthermore, quantification of wild‐type and pre‐core mutant HBV‐DNA was useful to predict the prognosis of anti‐HBe‐positive infection and evaluate the efficacy of antiviral therapy. J. Med. Virol. 58:332–337, 1999. © 1999 Wiley‐Liss, Inc.