A case-control study for early prediction of hepatitis B e antigen seroconversion by hepatitis B virus DNA levels and mutations in the precore region and core promoter
Version of Record online: 2 JUN 2003
Copyright © 2003 Wiley-Liss, Inc.
Journal of Medical Virology
Volume 70, Issue 4, pages 545–552, August 2003
How to Cite
Yamaura, T., Tanaka, E., Matsumoto, A., Rokuhara, A., Orii, K., Yoshizawa, K., Miyakawa, Y. and Kiyosawa, K. (2003), A case-control study for early prediction of hepatitis B e antigen seroconversion by hepatitis B virus DNA levels and mutations in the precore region and core promoter. J. Med. Virol., 70: 545–552. doi: 10.1002/jmv.10429
- Issue online: 2 JUN 2003
- Version of Record online: 2 JUN 2003
- Manuscript Accepted: 20 MAR 2003
- Ministry of Health, Labour and Welfare of Japan
- chronic hepatitis;
- hepatitis B surface antigen;
- case-control studies
Factors influencing and predictive of seroconversion from hepatitis B e antigen (HBeAg) to antibody (anti-HBe) were sought in a case-control study of 61 patients with chronic hepatitis B who had been observed from 5 years before to 1 year after seroconversion, and 32 patients who did not seroconvert during the entire 6-year period. Almost all of the patients (96%) were infected with HBV genotype C. HBV DNA levels began to decrease 3 years before seroconversion in the seroconverters, while they remained high in the non-converters. The frequency of precore mutation and the loss of HBeAg (A1896) started to increase 1 year before in the converters, and became significantly higher at seroconversion (23 vs. 3%, P = 0.030) than that in the non-converters. Double mutation in the core promoter (T1762/A1764) was more common in the seroconverters than in the non-converters 5 years before seroconversion (48 vs. 28%), and became significantly more frequent at seroconversion (65 vs. 41%, P = 0.046). Seroconversion occurred in 75% of the patients with at least HBV DNA levels <5.5 logarithmic equivalents/mL; precore mutation in 20% or more of HBV DNA; or core promoter mutation. Seroconversion occurred in 50% of those patients within 1 year, 88% within 2 years, and 93% within 5 years. These results indicate that a decrease in HBV DNA levels and mutations in the precore region and the core promoter were associated significantly and complementarily with seroconversion, and each of them or a combination thereof was predictive of seroconversion years ahead. J. Med. Virol. 70:545–552, 2003. © 2003 Wiley-Liss, Inc.