Pre-core mutant infections in the Canadian Inuit

Background/Aims: Previous cross-sectional data suggested that chronic hepat itis B viral (HBV) infections in the Canadian Inuit were inactive, The aim of this study was to confirm these findings and document the prevalence of the subsequently described "pre-core mutant" variant of HBV in this populat ion. Methods: We obtained sera from residents of five remote Canadian Inuit comm unities. Residents were selected if they were known to be hepatitis B surfa ce antigen (HBsAg) positive or had a history of liver disease, HBV serology , HBV-DNA, and pre-core mutant testing were performed by commercially avail able assays, polymerase chain reaction (PCR) and direct sequencing of the v iral genome, respectively, Results: Sera were obtained from 176/266 (66%) of selected individuals, Thi rty-eight (22%) were HBsAg positive and 16 (9.1%) anti-HBs positive, Of HBs Ag positive carriers 25/38 (66%) were male as compared to 68/138 (49%) of t he remaining individuals (p<0,05), Of 37 HBsAg positive carriers, none were HBeAg positive, 36 (97%) anti-Hue positive and one (3%) HBeAg and anti-Hue negative, Liver enzyme and function tests were normal in all cases. 30/37 (81%) HBsAg positive carriers were HBV-DNA positive and 26/30 (87%) were pr e-core mutant positive. Conclusion: The majority of HBV infections in community-based Canadian Inui t are inactive and the prevalence of pre-core mutant infections is the high est reported to date.