Kar Premashis, Polipalli Sunil K, Chattopadhyay Saket, Hussain Zahid, Malik Abdul, Husain Syed A, Medhi Subhash, Begum Nargis
PCR-Hepatitis Laboratory, Department of Medicine, Maulana Azad Medical College & Lok Nayak Hospital, New Delhi, India.
Dig Dis Sci. 2007 Feb;52(2):565-9. doi: 10.1007/s10620-006-9625-z. Epub 2007 Jan 9.
Hepatitis B is one of the most important causes of chronic viral hepatitis world wide. Mutations in the precore region of the hepatitis B virus (HBV) genome are frequently found in hepatitis B envelope antigen-negative cases. Data from India on the HBV genotype-associated distribution of precore mutations are limited. Our objective in this study was to genotype and detect the precore mutant with a point mutation from G to A at nucleotide 1896 using ligase chain reaction (LCR) and direct sequencing. A total of 115 cases of chronic liver disease were screened. The cases were evaluated on the basis of history, clinical examination, liver function profile, and serological test for HBV infection, which includes HBsAg, anti HBcIgG, HBeAg using commercially available ELISA kits. The cases, which were HBeAg+, HBeAg-, and HBV DNA+, were subjected to LCR and confirmed by direct sequencing. Of 115 chronic liver disease cases, 50 (43.5%) cases were HBV DNA positive. All cases were subjected to LCR; 11 (22%) cases confirmed the presence of precore mutants, while the remaining 39 (78%) were classified as the wild form of the virus. HBV genotyping by direct sequencing revealed that genotype D was predominant in both wild and mutant forms of the virus. We conclude that the HBV genotype distribution was not significantly different between precore mutants and the wild form of the virus (P>0.05). North Indian patients with genotype D were more likely to have persistent HBV infection with precore mutants. HBV genotypes correlate with the clinical outcome of chronic HBV infection.
乙型肝炎是全球慢性病毒性肝炎最重要的病因之一。在乙型肝炎表面抗原阴性的病例中，经常发现乙型肝炎病毒（HBV）基因组前核心区的突变。印度关于HBV基因型相关前核心突变分布的数据有限。本研究的目的是使用连接酶链反应（LCR）和直接测序对HBV进行基因分型，并检测核苷酸1896处由G到A的点突变的前核心突变体。共筛查了115例慢性肝病病例。根据病史、临床检查、肝功能检查以及HBV感染的血清学检测（包括使用市售ELISA试剂盒检测HBsAg、抗HBcIgG、HBeAg）对病例进行评估。对HBeAg阳性、HBeAg阴性和HBV DNA阳性的病例进行LCR检测，并通过直接测序进行确认。在115例慢性肝病病例中，50例（43.5%）HBV DNA呈阳性。所有病例均进行LCR检测；11例（22%）病例证实存在前核心突变体，其余39例（78%）被归类为病毒的野生型。通过直接测序进行的HBV基因分型显示，基因型D在病毒的野生型和突变型中均占主导地位。我们得出结论，前核心突变体与病毒野生型之间的HBV基因型分布没有显著差异（P>0.05）。北印度基因型D的患者更有可能持续性感染前核心突变体的HBV。HBV基因型与慢性HBV感染的临床结果相关。
