Abstract
ABSTRACT: Mutant hepatitis B virus (HBV), responsible for the lack of hepatitis B virus āeā antigen (HBeAg) secretion because of a translational stop codon at nucleotide 1896 of the HBV-DNA precore region (HBeAg minus HBV), has been detected worldwide in acute and chronic HBV infections and diseases. HBeAg minus HBV appears to condition the outcome of infection and to be involved in the pathogenesis of hepatitis B. We investigated the mutant prevalence and its clinical implications in 30 hepatitis B surface antigen/HBeAg-positive children (17 treated with interferon) with chronic hepatitis B. Wild-type and HBeAg minus HBV were characterized by quantitative oligohybridization assays in sera from 29 children followed up for a mean of 33 mo (12 mo to 9 y). At admission, 18 children (62%) circulated wild-type HBV alone; mutant HBV became detectable in two of them during the follow-up before HBeAg/anti-HBe seroconversion. Wild-type and HBeAg minus HBV were detected in 10 children (34.5%); mutant HBV levels were lower than 20% of total viremia in four of them and higher in six. Serum HBV-DNA from one child did not hybridize with our probes. HBeAg minus HBV was associated with older age (p < 0.009) and higher histologic activity (p < 0.069). HBeAg/anti-HBe seroconversion occurred independently from HBeAg minus HBV detection; it was observed in six (37.5%) of 16 children with wild-type HBV alone and in four (33.3%) of 12 children with mixed viremia. In cases with mixed viremia, seroconversion occurred in four (66%) of six with HBeAg minus levels lower than 20% of total viremia but in none of six with higher levels (p < 0.066). These findings suggest that HBeAg minus HBV can be detected in chronic HBV carrier children; it has relevant clinical implications and affects the outcome of both HBV infection and disease when its relative prevalence reaches values higher than 20% of total viremia.
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Barbera, C., Calvo, P., Coscia, A. et al. Precore Mutant Hepatitis B Virus and Outcome of Chronic Infection and Hepatitis in Hepatitis B e Antigen-Positive Children. Pediatr Res 36, 347ā350 (1994). https://doi.org/10.1203/00006450-199409000-00014
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DOI: https://doi.org/10.1203/00006450-199409000-00014