Core promoter mutations and genotypes in relation to viral replication andliver damage in East Asian hepatitis B virus carriers

Virus load and liver damage, as measured by quantitative polymerase chain r eaction and histology activity index, were related to genotype and core pro moter mutations in 43 chronic hepatitis B virus (HBV) carriers of East Asia n origin. T-1762 mutants were more frequent in genotype C strains and were associated with more inflammation (P = .0036) and fibrosis (P = .0088) of t he liver but not with hepatitis B e antigen (HBeAg) status or virus load. C onversely, precore mutations were associated with less liver inflammation ( P = .08), which was linked to HBeAg negativity and lower viral replication. Carriers with genotype C were more often HBeAg positive (P = .03) with pre core wild type strains and more-severe liver inflammation (P = .009) than w ere those with genotype B, These findings suggest that pathogenic differenc es between genotypes may exist and that the T-1762 mutation may be useful a s a marker for progressive liver damage but seem to contradict that down-re gulation of HBeAg production is the major effect of this mutation.