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Precore and core promoter mutants are associated with higher HBeAg seroconversion but low disease remission rates in HBV patients treated with nucleos(t)ide analogues


Correspondence: Prof. H.L.A. Janssen, MD PhD, Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, ‘s Gravendijkwal 230, room Ha 204, 3015 CE Rotterdam, The Netherlands.



HBeAg seroconversion in HBV patients is considered an important event. We determined precore (PC) and base core promoter (BCP) mutations in 137 HBeAg-positive nucleos(t)ide analogues (NA) treated patients by INNO-LiPA HBV PreCore assay (Innogenetics). The majority of patients with nongenotype A had PC/BCP mutants present at baseline (P = 0.02). During 29 months of therapy, 45 patients achieved HBeAg seroconversion. Probability of HBeAg seroconversion was higher in patients with PC and/or BCP mutants (= 0.01). After HBeAg seroconversion, patients with BCP mutants had more HBeAg relapse (= 0.07), and PC mutants less often achieved HBV DNA < 2000 IU/mL (= 0.07).