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Digestive Diseases and Sciences

, Volume 41, Issue 12, pp 2447–2452 | Cite as

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

  • Alessandra Mangia
  • Young-Hwa Chung
  • Jay H. Hoofnagle
  • Larry Birkenmeyer
  • Isa Mushahwar
  • Adrian M. di Bisceglie
Liver: Infectious, Inflammatory, And Metabolic Disorders

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.

Key words

hepatitis B variant HBeAg negative 

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Copyright information

© Plenum Publishing Corporation 1996

Authors and Affiliations

  • Alessandra Mangia
    • 1
    • 2
  • Young-Hwa Chung
    • 1
    • 2
  • Jay H. Hoofnagle
    • 1
    • 2
  • Larry Birkenmeyer
    • 1
    • 2
  • Isa Mushahwar
    • 1
    • 2
  • Adrian M. di Bisceglie
    • 1
    • 2
  1. 1.From the Liver Diseases Section, Digestive Diseases BranchNational Institute of Diabetes and Digestive and Kidney Disease, National Institutes of HealthBethesda
  2. 2.Abbott LaboratoriesNorth Chicago

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