Combination and Evolution of HBV Mutant Strains in the HBeAg-positive Status Predict Clinical Outcomes After HBeAg Seroconversion

Overview

Journal Hepatol Int

Publisher Springer

Specialty Gastroenterology

Date 2015 Jul 24

PMID 26201780

Citations 3

Authors

Chien-Hung Chen

Chuan-Mo Lee

Jing-Houng Wang

Tsung-Hui Hu

Chao-Hung Hung

Chi-Sin Changchien

Sheng-Nan Lu

Affiliations

Soon will be listed here.

Abstract

Purpose: We investigated whether the combined presence and evolution of hepatitis B virus (HBV) mutant strains in the hepatitis B e antigen (HBeAg)-positive status can predict clinical outcomes after HBeAg seroconversion.

Methods: One hundred and eighty-six patients with spontaneous HBeAg seroconversion were enrolled into this longitudinal study. The sequences of pre-S, core promoter, and precore regions were determined at study entry and at the visit immediately before HBeAg seroconversion.

Results: Age ≥40 years at HBeAg seroconversion, male sex, and higher HBV DNA levels at entry were independent predictors for HBeAg-negative chronic hepatitis B (CHB). Patients with combined mutations of pre-S deletions and T1762/A1764 had a significantly increased risk of cirrhosis and hepatocellular carcinoma (HCC) compared to patients with the wild type at both genomic regions. Combinations of pre-S deletions and T1762/A1764 were found on the same HBV genome by cloning analysis of full-length HBV genomes. Patients with a persistent presence of pre-S deletions and T1762/A1764 mutations, and new development of pre-S deletions in the HBeAg-positive status were significantly at an increased risk of HBeAg-negative CHB, cirrhosis, and HCC after HBeAg seroconversion than those with a persistent presence of the wild type at both genomic regions. After adjusting the other risk factors, the evolution of pre-S deletions was an independent predictor for cirrhosis [hazard ratio (HR): 1.52, 95 % confidence interval (CI) 1.02-2.25] and HCC (HR: 4.0, 95 % CI 1.6-10.1).

Conclusions: The combined presence and evolution of pre-S deletions and T1762/A1764 in the HBeAg-positive status was a useful factor significantly predictive of clinical outcomes in patients with spontaneous HBeAg seroconversion.

Citing Articles

Recent Advances in HBV Reactivation Research.

Guo L, Wang D, Ouyang X, Tang N, Chen X, Zhang Y Biomed Res Int. 2019; 2018:2931402.

PMID: 30687740 PMC: 6327272. DOI: 10.1155/2018/2931402.

Patients with interferon-induced HBeAg seroconversion have a higher risk of HBV reactivation and HBeAg seroreversion.

Chen C, Lu S, Lee C, Hung C, Wang J, Hu T Hepatol Int. 2015; 8(3):365-74.

PMID: 26202639 DOI: 10.1007/s12072-014-9542-8.

High risk of hepatitis B virus reactivation in nucleos(t)ide analogue-induced hepatitis B e antigen seroconverters older than 40 years.

Kuo L, Lee C, Hung C, Wang J, Hu T, Lu S Dig Dis Sci. 2014; 59(10):2580-7.

PMID: 24846794 DOI: 10.1007/s10620-014-3194-3.

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