Interferon Treatment on HBeAg Positive Chronic Hepatitis B with HBV Precore Mutant in Liver Tissue.
- Author:
Youn Jae LEE
1
;
Sung Cheul OK
;
Sang Hyuk LEE
;
Sang Young SEOL
;
Jung Myung CHUNG
;
Yeong Hong PARK
;
Nam Young JOO
Author Information
1. Department of Internal Medicine, In Je University College of Medicine.
- Publication Type:Original Article
- Keywords:
HBV precore mutant;
INF
- MeSH:
DNA;
Follow-Up Studies;
Hepatitis;
Hepatitis B e Antigens*;
Hepatitis B, Chronic*;
Hepatitis, Chronic*;
Humans;
Inflammation;
Interferon-alpha;
Interferons*;
Liver Diseases;
Liver*;
Natural History;
Pathology;
Polymerase Chain Reaction
- From:Korean Journal of Medicine
1998;55(1):43-51
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: This study investigates the prevalance of HBV precore mutant in chronic B hepatitis patients and whether HBV precore mutants affect hepatic inflammation and response to interferon alfa. METHODS: HBV DNA in liver tissue from 48 chronic hepatitis patients was amplified by polymerase chain reaction. The HBV precore mutants were detected by direct sequencing of amplified PCR products. Thirty-three HBeAg-positive patients (Group 1: wild- type, Group 2: mixed) were received 3-6 MU INF three times a week for 4-6 months. We did follow-ups for at least six months(mean : Group 1-11.3, Group 2- 13.7 months). A complete responder was defined as persistent(>6 months) normalization of transaminase and loss of HBeAg and/or seroconversion. RESULTS: The HBV precore mutants were found in 15 cases(31.2%) among 48 patients: 7 cases(21.2%) in 33 HBeAg-positive patients and 8 cases(53.3%) in 15 HBeAg-negative patients. The HBV precore mutants were more frequently found in HBeAg-negative patients(p= 0.043). Differences in severity of hepatic pathology were not observed in the wild-type versus mutant-type chronic hepatitis B patients(p =1.00). Initial response rate was not significantly different between two Groups(p= 0.228), but complete response rate had a lower tendency in Group 2 (p=0.073). CONCLUSION: There is a tendency for HBV precore mutants to be less responsive to INF therapy than wild type. Therefore the patients with chronic hepatitis B should be treated as early as possible in natural history of their liver disease before the emergence of HBV precore mutants.
