Properties of hepatitis B virus genome recovered from Vietnamese patients with fulminant hepatitis in comparison with those of acute hepatitis

Among the many mutations found in the hepatitis B virus (HBV) genome, some have been associated with fulminant hepatitis, as exemplified by precore-de fective mutations. The aim of this study was to determine whether such muta tions also are found in Vietnamese cases of fulminant hepatitis B. The full -genome nucleotide sequence of HBV in three patients with fulminant hepatit is (F-2, F-3, and F-6) and one with acute hepatitis (A-3), who were admitte d to Cho Ray Hospital, Ho Chi Minh City, Vietnam was ascertained. Additiona lly, two patients with fulminant hepatitis (F-1 and F-7) and three with acu te hepatitis (A-1, A-2, and A-5) were examined only for the precore/core re gion of HBV. Remarkably, the nonsense mutation at precore codon 28 (Trp82St op) was found in four of the five patients with fulminant hepatitis, while all the acute hepatitis patients harbored wild type tone had a mixture of w ild and mutant types). The missense mutations within the core region, Ile97 Leu and Pro130Ile/Thr/Ser, were also remarkable in fulminant hepatitis. Onl y F-2 was free from these precore/core mutations, but F-2 was unique in tha t it possessed a chimeric genotype: it could be classified into genotype C as a whole, but its X region was of genotype B, like the other four fulmina nt hepatitis isolates (F-1, F-3, F-6, and F-7). The codon 41 of the X prote in was Pro in all three fulminant hepatitis cases examined for this region, while it was Ser in the wild-type isolates of genotype B. Of note as negat ive data, the mutations C1653T and T1753M of the enhancer II (Enh II) and A 1762T and G1764A of the precore/core promoter regions, once reported to be relevant to severe or fulminant hepatitis, were not found in the present ca ses. The results with the Vietnamese cases of fulminant hepatitis corrobora ted results of previous studies with respect to the mutations Trp28Stop of precore and Ile97Leu and Pro130Ile/Thr/Ser of core, but not for the mutatio ns within Enh II and precore/core promoter region. Whether the Ser41Pro mut ation in the X region of genotype B HBV is Vietnam-specific or disease-spec ific deserves further investigation. J. Med. Virol. 61:23-28, 2000. (C) 200 0 Wiley-Liss, Inc.