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Implication of basal core promoter/precore mutants upon genotype and clinical outcome in the hepatitis B virus

Abstract number: R2481

Puche B., Palomares J.C., Nogales M.C., Figueruela B., Almeida C.V., Martin-Mazuelos E.

Background and Aim: Hepatitis caused by HBV is a major health problem worldwide, with more than 350 million people affected. Understanding the implication of HBV's virologic characteristics is important in the management of the disease. Our aim was to study genotype prevalence and to determine basal core promoter/precore (BCP/PC) mutations in a cohort of 61 Andalusian patients with different clinical features.

Materials and Methods: 61 samples with viral load >1,500 IU/ml from 61 patients (73.8% men, 26.2% women) were studied. 88.5% were HBeAg- and 11.5% were HBeAg+. 59% patients were diagnosed of chronic hepatitis B (CHB), 31.1% of liver chirrosis (LC) and 9.8% were inactive carriers (IC). Viral load was measured by real-time PCR using the COBAS Ampliprep/Taqman technology (Roche Diagnostics). Genotypes were determined sequencing the surface gene using the Trugene HBV genotyping kit (Siemens). BCP/PC mutations were determined by semi-nested PCR amplification (using primers RMD26–Ci1 in the first round and RMD26–PC1 in the second round) and sequencing of the core gene using the 7-Deaza-dGTP-Cy5/Cy5.5 Dye Primer Sequencing Kit (Siemens). Statistical analysis were performed with SPSS version 14.0.

Results: 60.7% were genotype D, 34.4% genotype A, 3.3% genotype F, 1.6% genotype B and 1.6% genotype F. Only patients with CHB, LC and genotypes D and A were included in this study. BCP and/or PC mutations were detected in 83.4% of CHB patients, 95% of LC patients, 92% of genotype D and 81% of genotype A patients. The most abundant BCP/PC mutations are shown in Table 1.

Table 1

In the statistical analysis, we compared these mutations with genotypes and clinical status. Statistical significance (p leqslant R: less-than-or-eq, slant 0.005) was observed between T1753C, G1896A and genotype D and between T1768A and patients with LC.

Conclusions: 1 – HBV genotype D is the most prevalent in Andalusia, followed by genotype A. 2 – Double mutation A1762T–G1764A were the most frequent changes in the BCP region and G1896A in the PC region. 3 – Due to the predominance of genotype D in our population and its association with mutations T1753C and G1896A, high prevalence of these are expected in those areas where genotype distribution is similar to ours. 4 – Although we could associate mutation T1768A and chirrotic status, more studies are necessary to confirm our data and to establish a clear relationship between this and other mutations with clinical outcome.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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