Hepatitis B virus genotype B with G1896A and A1762T/G1764A mutations is associated with hepatitis B related acute-on-chronic liver failure
Article first published online: 7 JUL 2011
Copyright © 2011 Wiley-Liss, Inc.
Journal of Medical Virology
Volume 83, Issue 9, pages 1544–1550, September 2011
How to Cite
Xiao, L., Zhou, B., Gao, H., Ma, S., Yang, G., Xu, M., Abbott, W. G.H., Chen, J., Sun, J., Wang, Z. and Hou, J. (2011), Hepatitis B virus genotype B with G1896A and A1762T/G1764A mutations is associated with hepatitis B related acute-on-chronic liver failure. J. Med. Virol., 83: 1544–1550. doi: 10.1002/jmv.22159
- Issue published online: 7 JUL 2011
- Article first published online: 7 JUL 2011
- Manuscript Accepted: 17 MAY 2011
- Major State Basic Research. Grant Number: 2007CB512901
- Key Program of Guangzhou Medical Science. Grant Number: 2008-201-11
- National Grand Program on Key Infectious Disease. Grant Number: 2008ZX10002-004
- hepatitis B virus;
- acute-on-chronic liver failure
The existence of statistical associations between hepatitis B-related acute-on-chronic liver failure and both hepatitis B virus (HBV) genotype and mutations in the basal core promoter (BCP) and precore (PC) regions needs to be confirmed. A total of 322 patients with a chronic HBV infection, including 77 with hepatitis B-related acute-on-chronic liver failure, 109 with hepatocellular carcinoma (HCC) and 136 with chronic hepatitis B (CHB) were enrolled. The HBV genotype and the presence of mutations in the BCP/PC regions were determined by direct sequencing, and the frequencies were compared in the three patient groups. Overall, 198/322 (61.5%) were infected with genotype B and 124/322 (38.5%) with genotype C. Genotype B was significantly more frequent in patients with acute-on-chronic liver failure than CHB (92.2% vs. 60.3%, P < 0.001). As a contrast, genotype C was more common in patients with HCC than CHB (58.7% vs. 39.7%, P = 0.003). In genotype B patients, the A1762T/G1764A, A1846T, and G1896A mutations were significantly more prevalent in patients with acute-on-chronic liver failure than CHB (50.7% vs. 28.0%, P = 0.004; 59.2% vs. 34.1%, P = 0.002; 69.0% vs. 41.5%, P = 0.001, respectively). In multivariate analysis, the risk factors for acute-on-chronic liver failure were genotype B, A1762T/G1764A, and G1896A. In conclusion, CHB patients with genotype B, G1896A, and A1762T/G1764A had a higher tendency to develop liver failure than patients with genotype C. Therefore, HBV genotyping and detecting G1896A and A1762T/G1764A mutations might have important clinical implications as predictive risk factors for hepatitis B-related acute-on-chronic liver failure. J. Med. Virol. 83:1544–1550, 2011. © 2011 Wiley-Liss, Inc.