Korean Scientists, Lee et al., in their epidemiological molecular investigation identified specific W4P/R preS1 mutation of hepatitis B virus (HBV) in male patients with genotype C of chronic infection. They indicate that it may contribute to hepatitis progression and the development of hepatocellular carcinoma (HCC).
HBV infection is a global health problem that affects 30% of the population. More than 350 million (5% of the population) of this percentage suffer from chronic hepatitis B (CHB). In approximately 30% of patients in the world (especially in antivirally untreated), chronic infection with HBV leads to the development of cirrhosis and predispose to liver cancer: hepatocellular carcinoma. HCC is the sixth most prevalent cancer worldwide and the third in annual cancer mortality rates. The risk of HCC is about 100 times higher in HBV-infected people than in others. There are geographical differences in cancer incidence. The highest number of cases (about 80%) is recorded in the region of South -East Asia and Africa.
Fast integration of viral genetic material with hepatocytes’ genetic material, high instability of HBV genome and occurring mutations foster the development of HCC. The risk of its occurrence increases when virus replication in host cells intensifies. What is more HBV genotypes may also have an impact on chronic hepatitis progression and HCC.
Lee et al. in their research examined a group of 292 patients (225 men and 67 women) with chronic HBV infection who were treated in 3 Korean hospitals. First of all, they analyzed if serum samples collected from patients contained hepatitis B e antigen (HBeAg). It is an important marker of high viral replication in hepatocytes and when it is persistent for over 10 weeks it is an evidence of chronic hepatitis. In order to detect W4P/R mutation in preS1 region in HBV genome the scientists used real-time polymerase chain reaction (RT – PCR) with molecular probes based on fluorescence resonance energy transfer (FRET). This method made possible to detect and separate 3 different types of variants: wild, W4P and W4R.
Literature data show that hepatocellular carcinoma is five times more common in men than in women. High ratio of HCC incidence in males can be explained with Lee et al. research which suggest that newfound W4P/R mutation of HBV is responsible for that situation. The mutations were not found in females.
.In conclusion, occurrence of new detected HBV genome mutation can be associated with a higher incidence of hepatocellular carcinoma in HBV-infected men. Owing to this discovery the epidemiology of HBV infection will be better understood and it may be an excellent prognostic tool for finding chronic infection patients with an increased risk of liver cirrhosis and HCC development.
Written by: Małgorzata Kozioł, Agnieszka Sikora
Source:
1. Seoung-Ae Lee, Ki-Jeong Kim,Dong-Won Kima, Bum-Joon Kima: Male specific W4P/R preS1 mutation of Hepatitis B virus increasing the risk for the progression of liver diseases of chronic patients. J. Clin. Microbiol. 2013; doi:10.1128/JCM.01505-13, online: http://www.asm.org/images/Communications/tips/2013/1013hbv.pdf
2. Kew M.C.: Epidemiology of chronic hepatitis B virus infection, hepatocellular carcinoma, and hepatitis B virus-induced hepatocellular carcinoma. Pathologie Biologie 2010; 58,4: 273-277.
3. Krzakowski M., Krzysztof Zieniewicz K., Habior A. i wsp.: Rak wątrobowokomórkowy— rozpoznanie i leczenie. Onkol. Prak. Klin. 2009; 5, 4: 125–140.
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Importance of newfound mutation of HBV virus: W4P/R
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