Objective: To clarify the association of hepatitis B virus mutants in precore and core promoter regions in patients with hepatic failure and HBeAg state.
Methods: Precore and core promoter regions of 25 HBV isolates from the patients with hepatic failure were analyzed by polymerase chain reaction (PCR) direct sequencing approach.
Results: Precore G-to-A(1896) mutants were identified in 16 (64%) of the 25 isolates. The "hot spot" mutations at A-to-T(1762) and G-to-A(1764) were present together in 19 (76%) of the 25 isolates, while C-to-T(1653) and T-to-C(1753) existed in a mutually exclusive manner and more frequently in hepatic failure with liver cirrhosis group than in hepatic failure with chronic hepatitis group (100% vs 50%). Both A(1896) and T(1762)-A(1764) could be found frequently in HBeAg-positive subjects (77.8% and 88.9%), whereas T(1653)/C(1753) was more prevalent in anti-HBe-positive subjects than in HBeAg-positive subjects (93.8% vs 33.3%).
Conclusions: The whole frequency of mutations in precore and core promoter gene will become more frequent as HBV infection is to be persistent. Mutation to T(1653)/C(1753) may be useful as a marker for hepatic failure. It requires further study whether the mixed infection of mutants and wilds will develop and affect the condition of HBeAg in serum along the progression of liver disease.