ZT: 前C区变异的讨论

liver411

谢谢帮忙翻译. 不错的文章. [B]Precore Mutations Occur Early in HBV Infection but Do Not Worsen Outcomes[/B] By Brian Boyle, MD Hepatitis B virus (HBV) precore mutants have been detected in 4%–10% of hepatitis B e antigen (HBeAg)-positive patients. It is currently thought that precore mutants emerge due to the selective pressure that occurs during the process of HBeAg seroconversion. Some studies have suggested that precore mutants are associated with more severe HBV-related liver disease, however, other studies have not confirmed this finding. In a study published in The Journal of Infectious Diseases, investigators sought to assess the relationship between the development of precore and core promoter mutants and HBeAg seroconversion and the clinical effect of these mutations. The study enrolled 376 Chinese patients with chronic HBV seen at a hospital in Hong Kong between January 1999 and December 2001. The majority of these patients had no biochemical or clinical evidence of cirrhosis at presentation and subsequent follow-up; however, 20 presented with hepatocellular carcinoma and/or other cirrhosis-related complications, and 24 developed complications during the follow-up period. The investigators found that 50% of patients <30 years of age had precore mutations and that there was no significant difference in the prevalence of precore mutations between the different age groups. The prevalence of precore mutations was 44.2% among HBeAg–positive patients and 56.5% in anti-HBe–positive patients (p=.031). There were no significant differences in the alanine aminotransferase (ALT) and HBV DNA levels between patients with and without precore mutations. Further, the median HBV DNA level in anti-HBe–positive patients was elevated irrespective of the presence or absence of precore mutations. Finally, there was no difference in the prevalence of precore mutations between patients with and without complications. Based upon these findings, the authors conclude, “to our knowledge this study was the first study to show that precore mutations occurred early in chronic HBV infection among the Chinese. The development of cirrhosis related complications and HCC was unrelated to precore mutations, but was probably due to the persistence of significant viremia after HBeAg seroconversion. Core promoter mutations might also play a role.” 10/23/02 Reference M Yuen and others. Relationship between the Development of Precore and Core Promoter Mutations and Hepatitis B e Antigen Seroconversion in Patients with Chronic Hepatitis B Virus. The Journal of Infectious Diseases. 2002; 86:1335–8. Copyright 2002 by HIV and Hepatitis. All Rights Reserved. Reproduction of articles for personal or educational use is encouraged and does not require permission from the publisher.

rising

草草地译了一下，请多指正。

HBV感染早期前C区变异，但并未使预后变坏

HBV前C区变异可在4%-10%的E抗原阳性病人中检测到，目前认为前C区变异的出现是由于E抗原血清转换过程中的选择性压力造导致的。一些研究认为前C变异与HBV感染性肝病病情加剧有关，但在某些研究中并未得到证实。

在一篇发表在感染病杂志的研究中，研究者试图评估前C区和C区启动子变异与E抗原血清转换间的关系，以及这些变异的临床影响。这项研究包括1999年1月至2001年12月间在香港一家医院就诊的376名慢性HBV感染的中国病人，其中大多数在就诊及以后的随访中没有肝硬化的生化或临床方面的证据，但是，20名病人出现肝细胞癌和/或其他肝硬化相关的并发症，24名病人在随访期出现并发症。

研究者发现50%的年龄小于30岁的病人有前C区变异，不同组别间前C区变异的发生率无明显差别，在E抗原阳性的病人中前C区发生率为44.2%，E抗体阳性的病人中则为56.5%（P=.031）。

有无前C区变异的病人在ALT、HBVDNA水平上无明显差异，另外，在E抗体阳性的病人中，不管是否出现前C区变异，其DNA中性值升高。最后，有伴有和不伴有并发症的病人中前C区变异的发生率无差异。

就以上数据，作者总结到，“据我们所知，这项研究是表明在慢性HBV感染的中国人中早期发生前C区变异的首次研究，肝硬化相关的并发症及肝细胞癌的发展与前C区变异无关，但可能归因于E抗原血清转换后持续存在的明显的病毒血症，C区启动子变异也可能参与其中”。

10/23/02

参考文献（略）

可可

不错！谢谢两位。

lxx00630

没有特效药，讨论有什么用

大排长

最起码是安慰我们前C变异 的。