The relationship between gene mutation in the pre-C region of hepatitis B virus and acute-on-chronic liver failure associated with hepatitis B
10.3760/cma.j.cn431274-20240128-00192
- VernacularTitle:乙型肝炎病毒前C区基因突变与乙型肝炎相关性慢加急性肝衰竭的关系
- Author:
Xinghua CUI
1
;
Yi YANG
;
Ting SUN
;
Junfei DONG
Author Information
1. 中国人民解放军北部战区总医院感染科，沈阳 110000
- Keywords:
Hepatitis B virus;
Mutation;
Hepatitis B, chronic;
Acute-on-chronic liver failure
- From:
Journal of Chinese Physician
2024;26(10):1540-1543
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the relationship between gene mutation in the pre-C region of hepatitis B virus (HBV) and acute-on-chronic liver failure (ACLF) associated with hepatitis B.Methods:Fifty-eight patients with chronic hepatitis B (CHB) admitted to the General Hospital of Northern Theater Command of the Chinese People′s Liberation Army from May 2020 to May 2023 were selected as the CHB group, 51 patients with chronic hepatitis B liver cirrhosis (CHB-LC) were selected as the CHB-LC group, and 52 patients with hepatitis B-related acute-on-chronic liver failure were selected as the ACLF group. The clinicopathological data of the three groups were collected for retrospective analysis. Peripheral serum HBV DNA of the three groups was collected. The pre-C region genes of HBV in the three groups were amplified by real-time fluorescent quantitative polymerase chain reaction (qRT-PCR), and then gene sequencing was performed. The variation at position 1896 of the pre-C region gene of HBV in the three groups was recorded. The general data, hepatitis B e antigen (HBeAg), HBV DNA quantification, triglycerides (TG), total cholesterol (TC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN), and gene mutation in the pre-C region of the three groups were observed and compared. Logistic regression analysis was performed on the related influencing factors of the onset of hepatitis B-related ACLF.Results:There were no statistically significant differences in gender, age, disease course, body mass index (BMI), TG, TC, and BUN among the three groups (all P>0.05), and there were statistically significant differences in HBeAg, HBV DNA quantification, ALT, and AST among the three groups (all P<0.05). The HBV DNA quantification, ALT, and AST in the ACLF group were higher than those in the CHB group and the CHB-LC group (all P<0.05). The mutation rate at position 1896 of the pre-C region gene of HBV in the ACLF group was higher than that in the CHB group and the CHB-LC group (all P<0.05); The results of logistic multivariate regression analysis showed that HBV DNA quantification, ALT, and gene mutation in the pre-C region were independent influencing factors for the onset of hepatitis B-related ACLF ( OR=1.042, 1.570, 1.413, P<0.05). Conclusions:The variation at position 1896 of the pre-C region gene of HBV is common in patients with HBV infection at different disease courses. The incidence of its variation shows a gradually increasing trend in CHB, CHB-LC, and ACLF. Elevated HBV DNA and ALT and gene mutation in the pre-C region of HBV are independent risk factors for the occurrence of hepatitis B-related ACLF. The progress of the disease in such patients requires clinical attention.
