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Pathogenesis of chronic liver disease in patients with chronic hepatitis B virus infection without serum HBeAg

Digestive Diseases and Sciences volume 41, pages 2447–2452 (1996)Cite this article

Abstract

Chronic hepatitis B in patients lacking hepatitis B e antigen has been attributed to a hepatitis B virus variant (G-to-A mutation at nucleotide 1896 in the precore region of the genome). We therefore assessed the frequency and significance of this variant among 43 United States patients (10 with chronic hepatitis B seropositive for e antigen, 19 seronegative for e antigen, and 14 healthy carriers). Sera were tested for HBV DNA by polymerase chain reaction and branched DNA assay. The A1896 variant was detected by direct sequencing and ligase chain reaction. Serum HBV DNA was more frequently found among patients with e antigenpositive than e antigen-negative chronic hepatitis B. Viral titers were generally higher in those with e antigen. None of the e antigen-positive and only 24% of e antigen-negative patients harbored the A1896 variant. Patients infected with the variant were more often Asian, had had hepatitis B for longer and had higher levels of viral DNA than HBeAg-negative patients with the wild-type virus. The A1896 variant was found exclusively in patients infected with HBV genotypes C and D. Thus, the A1896 variant is uncommon in the United States. The activity of liver disease appears to be more closely related to the level of HBV replication than the presence of mutations at nucleotide 1896 in the genome.

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Author notes

  1. Alessandra Mangia MD

    Present address: IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy

  2. Adrian M. di Bisceglie MD

    Present address: Department of Internal Medicine, St. Louis University Health Sciences Center, St. Louis, Missouri

Affiliations

  1. From the Liver Diseases Section, Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Disease, National Institutes of Health, Bethesda, Maryland

    Alessandra Mangia MD, Young-Hwa Chung MD, Jay H. Hoofnagle MD, Larry Birkenmeyer PhD, Isa Mushahwar PhD &  Adrian M. di Bisceglie MD

  2. Abbott Laboratories, North Chicago, Illinois

    Alessandra Mangia MD, Young-Hwa Chung MD, Jay H. Hoofnagle MD, Larry Birkenmeyer PhD, Isa Mushahwar PhD &  Adrian M. di Bisceglie MD

Authors
  1. Alessandra Mangia MD
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  2. Young-Hwa Chung MD
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  3. Jay H. Hoofnagle MD
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  4. Larry Birkenmeyer PhD
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  5. Isa Mushahwar PhD
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  6. Adrian M. di Bisceglie MD
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Mangia, A., Chung, YH., Hoofnagle, J.H. et al. Pathogenesis of chronic liver disease in patients with chronic hepatitis B virus infection without serum HBeAg. Digest Dis Sci 41, 2447–2452 (1996). https://doi.org/10.1007/BF02100141

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  • DOI: https://doi.org/10.1007/BF02100141

Key words

  • hepatitis B
  • variant
  • HBeAg negative