Kheirabad Ali Kargar, Farshidfar Gholamreza, Nasrollaheian Sadegh, Gouklani Hamed
Ph.D., Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Ph.D., Department of Biochemistry, School of Medicine, Hormozgan University of Medical Sciences, Iran.
Electron Physician. 2017 Apr 25;9(4):4114-4123. doi: 10.19082/4114. eCollection 2017 Apr.
Mutation of the HBV precore gene prevents the production of HBeAg, which is an important target for immune responses. Distribution of this mutation varies along with frequency of HBV genotypes in accordance with geographic and ethnic variations. The general objective of this study was to evaluate the prevalence and characteristics of precore mutation in Iran and its correlation with genotypes of hepatitis B.
In this cross-sectional study, viral DNA of 182 Iranian hepatitis B surface antigen positive patients who were admitted to Bandar Abbas Blood Transfusion Organization in 2012 and 2013 was retrieved from their serum samples. HBeAg, anti-HBe, and anti-HBc IgM diagnostic tests were performed using ELISA kits. Precore and Pre-S regions were amplified using specific primers and PCR thereafter to determine the genotypes; precore mutation, PCR, and restriction fragment length polymorphism (RFLP) methods also were applied. SPSS version 12 was used for data analysis by Mann-Whitney U test, Fisher's exact probability test, and t-test.
A total of 62 patients (34.1%) had precore mutation (A1896G), and genotype D was the predominant genotype in these patients, which was followed by an unknown genotype that was suspected for genotype B. Interestingly, the relationships between precore mutation and HBeAg (p=0.037) and genotype D (p=0.005) were significant; however, no correlation was observed between this mutation and acute or chronic hepatitis and sex of patients.
This study found high prevalence of precore mutations in southern Iran, which was significantly associated with HBeAg and genotype D.
乙肝病毒前核心基因的突变会阻止HBeAg的产生，而HBeAg是免疫反应的一个重要靶点。这种突变的分布会随着乙肝病毒基因型的频率，根据地理和种族差异而变化。本研究的总体目标是评估伊朗前核心突变的流行情况和特征及其与乙肝基因型的相关性。
在这项横断面研究中，从2012年和2013年入住阿巴斯港输血组织的182例伊朗乙肝表面抗原阳性患者的血清样本中提取病毒DNA。使用ELISA试剂盒进行HBeAg、抗-HBe和抗-HBc IgM诊断检测。使用特异性引物和PCR扩增前核心区和前S区，然后确定基因型；还应用了前核心突变、PCR和限制性片段长度多态性（RFLP）方法。使用SPSS 12版软件，通过曼-惠特尼U检验、费舍尔精确概率检验和t检验进行数据分析。
共有62例患者（34.1%）发生前核心突变（A1896G），基因型D是这些患者中的主要基因型，其次是一种疑似基因型B的未知基因型。有趣的是，前核心突变与HBeAg（p = 0.037）和基因型D（p = 0.005）之间的关系具有显著性；然而，未观察到这种突变与急性或慢性肝炎以及患者性别之间存在相关性。
本研究发现伊朗南部前核心突变的发生率很高，这与HBeAg和基因型D显著相关。
