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Low prevalence of hepatitis B virus pre‐s deletion mutation in Indonesia

The molecular epidemiological study of hepatitis B virus (HBV) in Indonesia is still limited. This study was aimed to identify the prevalence of HBV pre‐S deletion/insertion mutations, and to assess the association of pre‐S deletion mutation with liver disease progression in Indonesia. Pre‐S mutations were identified by direct sequencing. Of the 265 subjects, 32 samples (12.1%) harbored pre‐S deletion/insertion mutations. The prevalence of those pre‐S mutations was 2.7% (2/75), 12.9% (8/62), 16.7% (11/66), and 17.7% (11/62) in asymptomatic carrier, chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma groups, respectively. Statistical analysis showed significant difference among them (P = 0.024). In HBV genotype B (HBV/B), pre‐S1, pre‐S1/S2, and pre‐S2 deletion mutations were detected respectively in 3 (17.6%), 4 (23.5%), and 9 (52.9%) of 17 samples. On the other hand, in HBV/C, 12 of 15 samples (80.0%) showed a pre‐S2 deletion mutation, and only 2 samples (13.3%) demonstrated a pre‐S1/S2 deletion mutation. These results suggest that in HBV/B deletion mutation tends to occur in pre‐S1 or pre‐S1/S2 region, while in HBV/C the deletion mutation usually occurs in the pre‐S2 region. Analysis of complete genome of four viruses confirmed that 3 isolates were classified into HBV/B3, and 1 isolate was HBV/C1. However, SimPlot and BootScan analyses showed that isolate 08.10.002 was an intragenotypic recombinant between HBV/B3 and HBV/B4. As conclusion, the prevalence of HBV pre‐S mutations was relatively low in Indonesian patients compared to those from Taiwan, Japan, and other Asian countries. There was a weak association between pre‐S deletion mutation and progressive liver disease. J. Med. Virol. 83:1717–1726, 2011. © 2011 Wiley‐Liss, Inc.