A long-term follow-up analysis of serial core promoter and precore sequences in Japanese patients chronically infected by hepatitis B virus

To investigate the association of hepatitis B virus (HBV) with core promote r mutation (T(1762)A(1764)) or precore mutation (A(1896)) with the clinical course of illness, we analyzed serial core promoter and precore sequences in 22 patients with HBV-associated chronic liver disease who were followed for 12 +/- 4 years (mean +/- SD). Sixteen of 22 patients were positive for HBeAg at baseline, and 15 of the 16 patients seroconverted to anti-HBe duri ng the observation period. T(1762)A(1764) mutation was detected in 16 of 22 patients, including 11 patients positive for HBeAg, at baseline. During th e follow-up period, A(1896) mutation emerged in 7 of 16 patients who had th e wild-type HBV or only the T(1762)A(1764) mutation at baseline. Sustained remission of hepatitis correlated with the low level of viremia, but did no t with type of mutations. These results indicate that HBV with T(1762)A(176 4) mutation tends to precede A(1896) mutation during the course of infectio n in Japanese patients with chronic liver disease.