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High rate of core promoter and precore mutations in patients with chronic hepatitis B

Sumbella F Baqai1, James Proudfoot, Debbie H Yi

  • 1Department of Internal Medicine, Alameda County Medical Center, 1411 E. 31st St., Oakland, CA, 94602-1018, USA, sumbella@gmail.com.

Hepatology International
|March 20, 2015
PubMed

Insights

Precore (PC) and core promoter (CP) mutations in chronic hepatitis B virus (CHB) infection may be linked to milder liver disease. Further studies are needed to confirm this association and guide treatment decisions.

Area of Science:

  • Hepatology
  • Virology
  • Genetics

Background:

  • Prevalence of precore (PC) and core promoter (CP) mutations in chronic hepatitis B virus (CHB) infection and their impact on liver disease are not well-defined in the US.
  • Understanding these mutations is crucial for managing CHB patients.

Purpose of the Study:

  • To investigate the prevalence of PC and CP mutations in CHB patients in the US.
  • To analyze the association between PC/CP mutations and liver disease severity, including HBV DNA levels and alanine aminotransferase (ALT) levels.
  • To evaluate the relationship between ALT levels and cirrhosis incidence.

Main Methods:

  • Retrospective chart review of 1,186 CHB patients using a cross-sectional approach.
  • Testing for HBV e antigen (HBeAg) and PC/CP mutations.
  • Analysis of HBV DNA and ALT levels, and incidence of cirrhosis based on ALT levels.

Main Results:

  • 80% of patients tested for mutations had PC or CP mutations.
  • PC or CP mutations were more prevalent in HBeAg-negative (89%) than HBeAg+ (56%) patients.
  • Patients with both mutations had lower ALT levels; those with only PC mutations had lower HBV DNA levels compared to those without mutations.
  • Cirrhosis incidence was higher in patients with ALT levels 1-2 × ULN and > 2 × ULN compared to those with ALT ≤ 0.5 × ULN.

Conclusions:

  • PC and CP mutations might be associated with milder liver disease in some CHB patients, suggesting a need for longitudinal studies.
  • The association between ALT 1-2 × ULN and increased cirrhosis incidence may warrant a re-evaluation of current treatment guidelines.
  • Findings could inform personalized treatment strategies for CHB patients with specific mutations.
Abstract

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