Association of HBV precore/core promoter variants with the degree of liver fibrosis in patients with HBeAg-positive chronic hepatitis B

Objective To investigate the association of hepatitis B virus ( HBV) precore/core promoter variants with liver pathological changes in patients with HBe Ag-positive chronic hepatitis B ( CHB) . Methods A total of 148 HBe Ag-positive CHB patients who were hospitalized in Guangzhou Eighth People's Hospital from April 2012 to December 2013, underwent liver biopsy, and had stored frozen serum samples were enrolled. Serum DAN was extracted and then nested PCR was used for the multiplication and sequencing of the HBV precore/core promoter region. The Mann-Whitney U test was used for comparison of continuous data with heterogeneity of variance between two groups, and the chi-square test was used for comparison of categorical data between two groups; a logistic regression analysis was performed to identify the parameters associated with marked liver fibrosis. Results Of all patients, 116 ( 78. 4%) were found to have marked liver fibrosis ( ≥S2) by liver biopsy. Among the patients with ALT ≤upper limit of normal, 10 ( 58. 8%) had marked liver fibrosis; 11. 8% had T1753 V mutation, 35. 3% had A1762 T/G1764 A mutation, and 5. 9% had G1896 A mutation. The univariate logistic regression analysis showed that HBV A1762 T/G1764 A and G1896 A mutations were significantly associated with marked liver fibrosis ( P < 0. 05) , while age, sex, HBV genotype, and other HBV mutations were not associated with marked liver fibrosis. The multivariate logistic regression analysis showed that HBV A1762 T/G1764 A mutation ( odds ratio [OR]= 7. 098, P < 0. 001) and G1896 A mutation ( OR = 16. 816, P = 0. 007) were independently associated with marked liver fibrosis. Conclusion HBV precore/core promoter variants can be used as the risk factors for marked liver fibrosis in HBe Ag-positive CHB patients.