The development of a mutation in the precore region of the hepatitis B virus in a chronically infected individual.

Abstract

Over a 15-year period, a white American woman was observed to have progressive hepatitis B that underwent hepatitis Be antigen (HBeAg) positivity to anti-HBe positivity with development of cirrhosis. This patient was found to have a non-sense mutation in the second codon of the pre-C region of the hepatitis B virus genome after her anti-HBe seroconversion but not in her serum when she was HBeAg+. As controls, serial blood specimens were analyzed from 12 other American patients who spontaneously converted from HBeAg to anti-HBe, who underwent an interferon alfa-associated HBeAg to anti-HBe seroconversion, and who did not seroconvert with interferon alfa therapy. No mutations in the pre-C region were observed to arise in these individuals. In conclusion, non-sense mutations that occur in the pre-C region in locations other than the 28th codon can be associated with HBeAg negative progressive liver disease. This report of a non-sense mutation occurring over time is unusual in that it occurred in a white American patient.