Association of N-glycosylation mutation of HBV envelope protein with the development and prognosis of acute-on-chronic liver failure in patients with chronic hepatitis B

Objective To investigate the association of N-glycosylation mutation of HBV envelope protein with the development of acute-on-chronic liver failure ( ACLF) in patients with chronic hepatitis B ( CHB) . Methods A total of 90 patients with HBV-ACLF were enrolled, and 60 patients with CHB were enrolled as control group. Nested PCR was used for the multiplication and sequencing of HBV S region, and the association of N-glycosylation of HBV envelope protein with the development ACLF was analyzed, as well as the association of N-glycosylation of HBV envelope protein with the severity and 90-day survival rate of ACLF. Results A total of 51 CHB patients ( 85. 0%) and 79 HBV-ACLF patients ( 87. 8%) were included in analysis. Among the CHB patients, 33 ( 64. 7%) had Asn-59 N-glycosylation and 21 ( 41. 2%) had Asn-4 N-glycosylation, while among the HBV-ACLF patients, 16 ( 20. 3%) had Asn-59 N-glycosylation and 14 ( 17. 7%) had Asn-4 N-glycosylation; there were significant differences in the numbers of cases of Asn-59 and Asn-4 N-glycosylation between the two groups ( P < 0. 001, and P = 0. 003) . There were no significant differences in liver function, HBV DNA, Model for End-Stage Liver Disease score, and 90-day survival rate between the ACLF patients with Asn-59 and Asn-4 N-glycosylation and those without such glycosylation ( P > 0. 05) . Conclusion The reduction in Asn-59 and Asn-4 N-glycosylation induced by HBV envelope protein variation may be associated with the development of ACLF.