Core Promoter Mutations and Genotypes in Relation to Viral Replication and Liver Damage in East Asian Hepatitis B Virus Carriers

Abstract

Virus load and liver damage, as measured by quantitative polymerase chain reaction and histology activity index, were related to genotype and core promoter mutations in 43 chronic hepatitis B virus (HBV) carriers of East Asian origin. T-1762 mutants were more frequent in genotype C strains and were associated with more inflammation (P = .0036) and fibrosis (P = .0088) of the liver but not with hepatitis B e antigen (HBeAg) status or virus load. Conversely, precore mutations were associated with less liver inflammation (P =.08), which was linked to HBeAg negativity and lower viral replication. Carriers with genotype C were more often HBeAg positive (P = .03) with precore wild type strains and more-severe liver inflammation (P = .009) than were those with genotype B. These findings suggest that pathogenic differences between genotypes may exist and that the T-1762 mutation may be useful as a marker for progressive liver damage but seem to contradict that down-regulation of HBeAg production is the major effect of this mutation.