OUTCOME OF LIVER-DISEASE AND RESPONSE TO INTERFERON TREATMENT ARE NOTINFLUENCED BY HEPATITIS-B VIRUS CORE GENE VARIABILITY IN CHILDREN WITH CHRONIC TYPE-B HEPATITIS

Background/Aims: Hepatitis B virus (HBV) core gene heterogeneity may i nfluence the outcome of liver disease and the response to interferon ( IFN) therapy in adult HBV carriers. The aim of this study was to evalu ate the possible association between HBV core gene variability and evo lution of chronic hepatitis in children. Methods: We examined serum sa mples from 25 children with HBV chronic hepatitis and HBe antigen (HBe Ag) positivity who were followed-up for a mean of 7.4 years. Seven cas es spontaneously seroconverted to anti-HBe, becoming HBV healthy carri ers; nine cases were successfully treated with IFN; nine cases were no n-responders to IFN therapy. HBV-DNA was extracted from one serum samp le (''I'') collected during the HBeAg positive phase, and from a secon d sample (''II'') collected after the anti-HBe seroconversion or, in n on-responders, after stopping therapy. The entire core gene of the HBV isolates was amplified and sequenced. Results: Each isolate showed si ngle or no missense mutation independently of the clinical behavior of the patients. HBeAg-defective viruses were detected in one case in bo th samples and in two cases only in sample ''II''. Conclusions: Core g ene variability does not seem to be involved either in the outcome of infection or in the response to IFN treatment in children with HBV chr onic hepatitis. Considering that most of the HBV carriers in our area acquire the infection in childhood, our data suggest that core gene he terogeneity is not a major cause of progression to chronicity.