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Association of mutations in the core promoter and precore region of hepatitis virus with fulminant and severe acute hepatitis in Japan
Author(s) -
ARITOMI TOMOYUKI,
YATSUHASHI HIROSHI,
FUJINO TATSUYA,
YAMASAKI KAZUMI,
INOUE OSAMI,
KOGA MICHIAKI,
KATO YUJI,
YANO MICHITAMI
Publication year - 1998
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.1998.tb00588.x
Subject(s) - medicine , fulminant , virology , fulminant hepatitis , hepatitis b virus , hepatitis a virus , virus , hepatitis , immunology
It was recently reported that mutations in the precore and core promoter region of hepatitis B virus (HBV) are associated with fulminant hepatitis. The aim of this study was to investigate the association of mutations in the precore and core promoter region of HBV with fulminant and severe acute hepatitis. We studied Japanese patients with acute HBV infection, including seven patients with fulminant hepatitis, 12 with severe acute hepatitis and 41 with acute self‐limited hepatitis. The presence of HBV mutants was examined by using a point mutation assay to detect a G to A transition at position 1896 in the precore region and an A to T transition at position 1762 and a G to A transition at position 1764 in the core promoter region. Significant differences in the proportion of mutations in the precore or core promoter region were present between patients with fulminant hepatitis and self‐limited acute hepatitis (7/7 (100%) vs 4/41 (9.8%), P < 0.01) and between severe acute hepatitis and self‐limited acute hepatitis (6/12 (50.0%) vs 4/41 (9.8%), P < 0.01). The frequency of mutation increased proportionately with the severity of disease in patients with acute HBV infection. Fulminant hepatitis B in Japan is closely associated with mutations in the core promoter and precore gene of HBV. Point mutation assays for HBV precore and core promoter analysis may be useful to predict the outcome of liver disease in patients with acute HBV infection.