Cabrerizo M, Bartolomé J, Iñigo E R, López-Alcorocho J M, Cotonat T, Carreño V
Department of Hepatology, Fundación Jiménez Díaz, Madrid, Spain.
J Med Virol. 1998 Dec;56(4):294-9.
Serum samples from 20 anti-hepatitis B e antigen-positive patients with and without normal alanine aminotransferase (ALT) levels who had serum hepatitis B virus (HBV) DNA detectable only by polymerase chain reaction (PCR) were examined. Viral DNA was amplified by PCR, using primers that encompassed precore and ORF-X regions and sequenced directly, to investigate whether mutations in the nucleotide sequences of X and precore gene regions of HBV-DNA might be responsible for the difference in the activity of disease and in the levels of viral replication. The HBV-DNA concentration in patients with abnormal ALT levels was higher than in those with normal ALT. The amount of HBV-DNA correlated with the ALT levels (P < 0.05). Seventy-two percent of patients had HBV-DNA harboring the 1896 precore stop mutation, and there was a negative correlation between the percentage of precore mutant genotype and the HBV-DNA concentration (P < 0.05). Thirty percent of patients had mutations in ORF-X. Patients with ORF-X mutations had lower levels of HBV-DNA than those who had wild-type virus. The presence of mutations in precore and X regions may be related to a low HBV-DNA concentration and reduced biochemical activity in patients with anti-HBe.
对20例抗乙肝e抗原阳性、丙氨酸转氨酶（ALT）水平有正常和异常之分且血清乙肝病毒（HBV）DNA仅通过聚合酶链反应（PCR）可检测到的患者的血清样本进行了检测。通过PCR扩增病毒DNA，使用涵盖前核心区和ORF-X区的引物并直接测序，以研究HBV-DNA的X基因和前核心基因区域核苷酸序列中的突变是否可能是疾病活动度差异和病毒复制水平差异的原因。ALT水平异常患者的HBV-DNA浓度高于ALT水平正常的患者。HBV-DNA量与ALT水平相关（P<0.05）。72%的患者HBV-DNA存在1896前核心区终止突变，前核心突变基因型百分比与HBV-DNA浓度呈负相关（P<0.05）。30%的患者ORF-X区存在突变。存在ORF-X突变的患者HBV-DNA水平低于野生型病毒患者。前核心区和X区突变的存在可能与抗-HBe患者HBV-DNA浓度低和生化活性降低有关。
