Emergence and takeover of precore-stop mutant prior to exacerbation of e antigen-negative chronic hepatitis B after withdrawal of lamivudine therapy

✍ Scribed by Chau-Ting Yeh; Wei-Pin Lin; Chao-Wei Hsu; Ming-Ling Chang; Shi-Ming Lin; I-Shyan Sheen

• Publisher: John Wiley and Sons
• Year: 2006
• Tongue: English
• Weight: 149 KB
• Volume: 78
• Category: Article
• ISSN: 0146-6615
• DOI: 10.1002/jmv.20639

✦ Synopsis

Although hepatitis B virus (HBV) precore-stop mutant (nonsense mutation at codon 28) is usually isolated from patients with hepatitis B e antigen (HBeAg)-negative hepatitis, it is unclear whether the mutant is the cause of the hepatitis flare or it is a consequence of necroinflammation. Using the amplification-created restriction site method, the ratios of precore-stop mutant were measured in serial serum samples obtained from three patients experiencing HBeAg-negative hepatitis after withdrawal of lamivudine therapy. In all three patients, the precore-stop mutant emerged and took over the viral population at least 2 months prior to the hepatitis exacerbations. After the onset of exacerbation, transient elevation of serum HBV-DNA was observed, which was followed by progressive decrease of the ratio of precore-stop mutant as well as normalization of serum transaminases. The present data indicate that at least in some patients, the precore-stop mutant is the cause but not the consequence of the flare of HBeAgnegative hepatitis.