MUTATIONS OF HEPATITIS-B VIRUS CORRELATE WITH LIVER-DISEASE

Hepatitis B virus infection leads to a wide spectrum of liver injury, including self-limited acute hepatitis, fulminant hepatitis and chroni c hepatitis with progression to cirrhosis or acute exacerbation to liv er failure, as well as an asymptomatic chronic carrier state. The hepa titis B core antigen could be an immunological target of cytotoxic T l ymphocytes. To investigate the reason why the severe immunological att ack occurs, the entire precore and core region was sequenced. No signi ficant change in deduced amino acid residue was noted in all the asymp tomatic healthy carriers and all the self-limited acute hepatitis pati ents. In contrast, clustering changes in small segments of amino acids were found in all the patients with severe chronic liver disease and in all the fatal hepatitis cases. These data suggest that these region s with mutations may play an important role in the pathogenesis of hep atitis B viral disease, and such mutations are related to severe liver damage.