PDF(Pubmed)
Abstract：
BACKGROUND: Chronic hepatitis B (CHB) is well-known as a major risk for liver cirrhosis and hepatocellular carcinoma (HCC). The A1762T/G1764A double mutation in the hepatitis B virus genome affects the production of HBe antigen and is established as a predictive marker for progression to HCC. Thus, this study aimed to investigate the prevalence and clinical significance of the mutation in Thai CHB patients.
METHODS: A cross-sectional study was conducted in 78 Thai CHB patients who were assessed for hepatitis B profiles, HBsAg, HBeAg and anti-HBeAg, transaminitis, liver fibrosis defined by FIB-4 (FIB-4) score and AST to platelet ratio index (APRI), alpha-fetoprotein (AFP) and active hepatitis B status. HBV A1762T/G1764A mutation was examined by SYBR Green I Real-time PCR. Chi-square and Mann-Whiney U tests were performed to determine the association between the mutation and variables.
RESULTS: The prevalence of patients infected with the A1762T/G1764A mutation was 44.9%. The mutation was associated with HBeAg status (p=0.027) and HBsAg levels (p=0.008), transaminitis (p=0.011), and active hepatitis B (p=0.037), but not liver fibrosis markers, FIB-4 score and APRI, and AFP. Binary logistic regression identified the mutation as a predictive factor of active hepatitis B (OR 3.5, 95%CI, 1.1-11.3, p=0.037). Patients infected with the mutant exhibited significantly higher levels of HBsAg (p=0.011) and HBV viral load (p=0.047), but lower levels of HBeAg (p=0.12) than those infected with the wild-type HBV.
CONCLUSIONS: The data indicate the high prevalence of the A1762T/G1764A mutation and its significant association with the severity of Thai CHB patients and the HBV mutation is proposed as a predictive marker of active hepatitis B status in CHB patients.
METHODS: A cross-sectional study was conducted in 78 Thai CHB patients who were assessed for hepatitis B profiles, HBsAg, HBeAg and anti-HBeAg, transaminitis, liver fibrosis defined by FIB-4 (FIB-4) score and AST to platelet ratio index (APRI), alpha-fetoprotein (AFP) and active hepatitis B status. HBV A1762T/G1764A mutation was examined by SYBR Green I Real-time PCR. Chi-square and Mann-Whiney U tests were performed to determine the association between the mutation and variables.
RESULTS: The prevalence of patients infected with the A1762T/G1764A mutation was 44.9%. The mutation was associated with HBeAg status (p=0.027) and HBsAg levels (p=0.008), transaminitis (p=0.011), and active hepatitis B (p=0.037), but not liver fibrosis markers, FIB-4 score and APRI, and AFP. Binary logistic regression identified the mutation as a predictive factor of active hepatitis B (OR 3.5, 95%CI, 1.1-11.3, p=0.037). Patients infected with the mutant exhibited significantly higher levels of HBsAg (p=0.011) and HBV viral load (p=0.047), but lower levels of HBeAg (p=0.12) than those infected with the wild-type HBV.
CONCLUSIONS: The data indicate the high prevalence of the A1762T/G1764A mutation and its significant association with the severity of Thai CHB patients and the HBV mutation is proposed as a predictive marker of active hepatitis B status in CHB patients.
摘要：
背景：众所周知，慢性乙型肝炎（CHB）是肝硬化和肝细胞癌（HCC）的主要风险。乙型肝炎病毒基因组中的A1762T/G1764A双突变影响HBe抗原的产生，并被确立为进展为HCC的预测标志物。因此，这项研究旨在调查泰国CHB患者中突变的患病率和临床意义。
方法：在78泰国CHB患者中进行了一项横断面研究，这些患者被评估为乙型肝炎概况，HBsAg,HBeAg和抗HBeAg，转胺炎,由FIB-4（FIB-4）评分和AST与血小板比率指数（APRI）定义的肝纤维化，甲胎蛋白（AFP）和活动性乙型肝炎状态。通过SYBRGreenI实时PCR检查HBVA1762T/G1764A突变。进行卡方检验和Mann-WhineyU检验以确定突变和变量之间的关联。
结果：感染A1762T/G1764A突变的患者的患病率为44.9%。突变与HBeAg状态（p=0.027）和HBsAg水平（p=0.008）相关，转氨酶（p=0.011），和活动性乙型肝炎（p=0.037），但不是肝纤维化标志物，FIB-4评分和APRI，和AFP。二元逻辑回归确定突变为活动性乙型肝炎的预测因素（OR3.5，95CI，1.1-11.3，p=0.037）。感染突变体的患者表现出显着较高水平的HBsAg（p=0.011）和HBV病毒载量（p=0.047），但较低水平的HBeAg（p=0.12）比那些感染了野生型HBV。
结论：数据表明A1762T/G1764A突变的高患病率及其与泰国CHB患者的严重程度的显着关联，HBV突变被提议作为慢性乙型肝炎患者中活动性乙型肝炎状态的预测标志物。
方法：在78泰国CHB患者中进行了一项横断面研究，这些患者被评估为乙型肝炎概况，HBsAg,HBeAg和抗HBeAg，转胺炎,由FIB-4（FIB-4）评分和AST与血小板比率指数（APRI）定义的肝纤维化，甲胎蛋白（AFP）和活动性乙型肝炎状态。通过SYBRGreenI实时PCR检查HBVA1762T/G1764A突变。进行卡方检验和Mann-WhineyU检验以确定突变和变量之间的关联。
结果：感染A1762T/G1764A突变的患者的患病率为44.9%。突变与HBeAg状态（p=0.027）和HBsAg水平（p=0.008）相关，转氨酶（p=0.011），和活动性乙型肝炎（p=0.037），但不是肝纤维化标志物，FIB-4评分和APRI，和AFP。二元逻辑回归确定突变为活动性乙型肝炎的预测因素（OR3.5，95CI，1.1-11.3，p=0.037）。感染突变体的患者表现出显着较高水平的HBsAg（p=0.011）和HBV病毒载量（p=0.047），但较低水平的HBeAg（p=0.12）比那些感染了野生型HBV。
结论：数据表明A1762T/G1764A突变的高患病率及其与泰国CHB患者的严重程度的显着关联，HBV突变被提议作为慢性乙型肝炎患者中活动性乙型肝炎状态的预测标志物。
