Korean J Med.  1998 Jul;55(1):43-51.

Interferon Treatment on HBeAg Positive Chronic Hepatitis B with HBV Precore Mutant in Liver Tissue

Affiliations
  • 1Department of Internal Medicine, In Je University College of Medicine.
  • 2Department of Biochemistry, In Je University College of Medicine.
  • 3Department of Internal Medicine, Choon Hae Hospital.

Abstract

BACKGROUND
This study investigates the prevalance of HBV precore mutant in chronic B hepatitis patients and whether HBV precore mutants affect hepatic inflammation and response to interferon alfa.
METHODS
HBV DNA in liver tissue from 48 chronic hepatitis patients was amplified by polymerase chain reaction. The HBV precore mutants were detected by direct sequencing of amplified PCR products. Thirty-three HBeAg-positive patients (Group 1: wild- type, Group 2: mixed) were received 3-6 MU INF three times a week for 4-6 months. We did follow-ups for at least six months(mean : Group 1-11.3, Group 2- 13.7 months). A complete responder was defined as persistent(>6 months) normalization of transaminase and loss of HBeAg and/or seroconversion.
RESULTS
The HBV precore mutants were found in 15 cases(31.2%) among 48 patients: 7 cases(21.2%) in 33 HBeAg-positive patients and 8 cases(53.3%) in 15 HBeAg-negative patients. The HBV precore mutants were more frequently found in HBeAg-negative patients(p= 0.043). Differences in severity of hepatic pathology were not observed in the wild-type versus mutant-type chronic hepatitis B patients(p =1.00). Initial response rate was not significantly different between two Groups(p= 0.228), but complete response rate had a lower tendency in Group 2 (p=0.073).
CONCLUSION
There is a tendency for HBV precore mutants to be less responsive to INF therapy than wild type. Therefore the patients with chronic hepatitis B should be treated as early as possible in natural history of their liver disease before the emergence of HBV precore mutants.

Keyword

HBV precore mutant; INF

MeSH Terms

DNA
Follow-Up Studies
Hepatitis
Hepatitis B e Antigens*
Hepatitis B, Chronic*
Hepatitis, Chronic*
Humans
Inflammation
Interferon-alpha
Interferons*
Liver Diseases
Liver*
Natural History
Pathology
Polymerase Chain Reaction
DNA
Hepatitis B e Antigens
Interferon-alpha
Interferons
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