Knöll A, Rohrhofer A, Kochanowski B, Wurm E M, Jilg W
Institute of Medical Microbiology and Hygiene, University of Regensburg, Germany.
J Med Virol. 1999 Sep;59(1):14-8.
Hepatitis B virus (HBV) precore mutants are associated often with highly productive infection in hepatitis B surface antigen (HBsAg) carriers lacking hepatitis B e antigen (HBeAg) but positive for anti-HBe, rendering serological identification of infectious individuals unreliable. Although considered initially to be limited mostly to the Mediterranean area, more recent studies suggest a significant presence of these mutants in northern European countries. The sequence of the precore region was determined and examined for mutations from HBV isolates of 99 German chronic HBsAg carriers positive for HBV-DNA and either HBeAg (n = 15) or anti-HBe (n = 84). In addition, clinical data of individuals carrying wild-type virus and those with precore mutants were compared. HBV precore mutants were found in more than half (44/84) of all HBeAg-negative, anti-HBe-positive virus carriers. There was no difference between carriers of wild-type and precore mutant HBV in the level of viremia or in the clinical course of chronic infection. In conclusion, HBV precore mutants are common in Germany and can therefore present a diagnostic problem for serological testing. However, precore mutants do not appear to have a detrimental effect on the course of chronic HBV infection.
乙肝病毒（HBV）前核心区突变通常与乙肝表面抗原（HBsAg）携带者中高效感染相关，这些携带者乙肝e抗原（HBeAg）阴性但抗-HBe阳性，使得通过血清学方法鉴定有传染性的个体变得不可靠。虽然最初认为这些突变主要局限于地中海地区，但最近的研究表明，在北欧国家也大量存在这些突变。对99例德国慢性HBsAg携带者的HBV分离株的前核心区序列进行了测定并检测突变情况，这些携带者HBV-DNA阳性，且HBeAg阳性（n = 15）或抗-HBe阳性（n = 84）。此外，还比较了携带野生型病毒个体和携带前核心区突变个体的临床资料。在所有HBeAg阴性、抗-HBe阳性的病毒携带者中，超过一半（44/84）发现了HBV前核心区突变。野生型HBV携带者和前核心区突变HBV携带者在病毒血症水平或慢性感染临床进程方面没有差异。总之，HBV前核心区突变在德国很常见，因此可能给血清学检测带来诊断难题。然而，前核心区突变似乎对慢性HBV感染进程没有不利影响。
