| [ Summary ] |
It has recently been reported that mutations in the core promoter and precore gene of HBV are associated with fulminant hepatitis. We invesigated that the association of mutations in the core promoter and precore gene of HBV with fulminant and acute hepatitis, using Enzyme linked Mini-sequence Assays (ELMA). We studied patients with acute HBV infections, including 7 patients with fulminant hepatitis, 12 with acute hepatitis, 41 with acute self limited hepatitis. There were significant differences in the incidence of mutation in the precore or core promoter regions between fulminant hepatitis and self-limited acute hepatitis(7/7:100% vs 4/41:9.8%, p<0.01) and between severe acute hepatitis and self-limited acute hepatitis (6/12:50.0% vs 4141:9.8%, p<0.01). An apparent increase in mutation rate was observed, corresponding to the increase in of patients with acute HBV infection. In Japan, fulminant hepatitis B is closely associated with mutations in the core promoter and procore gene of HBV. ELMA for HBV precore and core promoter analysis might be used to predict the outcome of liver disease in patients with acute HBV infection. |