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[The clinical and pathology study of HBV precore mutant infection in chronic HBV patients].

OBJECTIVE
To elucidate the clinical feature, pathological change and IFN therapy of HBV pre-c mutant(1,896 G-->A point mutation).


METHODS
Mutation specific PCR was employed for detecting precore mutation from 108 serum and/or liver samples of patients with chronic hepatitis B infection. Liver damage was evaluated with Knodell's histology activity index(HAI) in 46 patients.


RESULTS
HBV precore mutant existed popularly in different e systems status, but the detective rate of HBV precore mutant or mutant prevailing over wild type in HBeAb+ group(14.29%, 46.23%) was significantly higher than that in HBeAg+(0%, 6.45%)group. Mutant infection was associated with the severity of liver diseases, the detective rate in severe chronic hepatitis group was significantly higher(13.64%, 40.91%) than that in chronic asympotamatic carriers groupe(0%, 15.62%). 5 precore mutant positive patients with IFN treatment showed either response or nonresponse to IFN therapy. There was no significant difference of liver pathological change between mutant type and wild type infection in patients with mild chronic hepatitis.


CONCLUSION
HBV precore mutant infection existed commonly in patients with chronic hepatitis B, despite of the e system status, though it was more prevalent in patients with HBeAb positive. Further study is needed in the pathogenicity and the treatment of HBV precore mutation.