Hot spot mutations of hepatitis B virus pre-C/C gene and its promotor in Chinese patients and the clinical implications

OBJECTIVE: To study if the functions of C gene and its promotor are related to the pathogenesis of hepatitis B and to describe their hot spot mutations in Chinese patients. DATA SOURCES: We have studied this subject in recent years. A mini-review is based on some unpublished works. DATA SELECTION: The sequence data of C gene and core promotor (cp) of hepatitis B virus (HBV) were analysed in the asymptomatic carriers (AsC) and the patients of hepatitis with various severity. RESULTS: Pre-C A1896 mutation occurred in 67% of anti-HBe-positive and 38% of HBeAg-positive cases. All were chronic infections. In C gene, 8 missense mutations in the segment of codon 48-60, and 28 in codon 84-101 were found, more in severe patients. The cp mutations of nt 1762 and nt 1764 occurred more in HBeAg-negative than in positive cases (49% vs 20%), and more in patients than in AsC (56% vs 10%). CONCLUSIONS: A1896 often occurred in nature infection course. The cp and clustering C gene mutations would more frequently lead to prolonged active infection and advanced liver diseases.