LOW-FREQUENCY OF PRECORE HEPATITIS-B VIRUS MUTANTS IN ANTI-HEPATITIS-BE-POSITIVE REACTIVATION AFTER LOSS OF HEPATITIS-BE-ANTIGEN IN PATIENTS WITH CHRONIC HEPATITIS-B

作者：LORIOT MA; MARCELLIN P; TALBODEC N; GUIGONIS V; GIGOU M; BOYER N; BEZEAUD A; ERLINGER S; BENHAMOU JP

来源：Hepatology, 1995, 21(3): 627-631.

The objective of this study was to evaluate the role of hepatitis B virus (HBV) precore mutations in patients with anti-HBe-positive chronic hepatitis B with or without previous known HBe antigen (HBeAg) viremic phase, and to assess the potential implication of precore mutants in HBeAg-negative reactivation after loss of HBeAg. Nineteen patients were studied: 7 had a previous HBeAg-positive phase and had spontaneous or therapeutically induced loss of HBeAg (group A); 12 had no previous HBeAg-positive phase (group B). Direct sequencing of PCR products was performed on serum collected during the anti-HBe-positive phase in the two groups, In group A, precore sequencing showed that 5 patients were infected by wild-type virus, 1 patient was infected with a precore mutant, and 1 patient was found to be infected by a mixture of wild-type and precore mutant viruses. In group B, precore sequencing showed that only 1 patient was infected with wild-type virus and that 11 were infected with precore mutants, In a few patients, the presence of HBeAg within immune complexes may explain HBeAg negativity, In conclusion, our results show that, in patients with anti-HBe-positive chronic hepatitis B: (1) precore mutations creating a stop codon are more frequently found in those without known previous HBeAg positivity; (2) after loss of HBeAg, the patients who have anti-HBe-positive reactivation are infected by wild-type virus, which suggests that reactivation is not related to precore mutations; (3) HBeAg negativity may be caused by immune complexes formation.

• 出版日期1995-3