Infection by hepatitis B virus (HBV) is a major global health-care problem. HBV is an accepted factor in the elevated risks for liver disease such as cirrhosis and development of hepatocellular carcinoma. This problem is particularly prevalent in the Asia-Pacific region which includes Malaysia. During infection, the hepatitis B e antigen (HBeAg) is produced in the hosts. This antigen is an important serological marker for diagnosing chronic hepatitis B. Seroconversion to anti-body (anti-HBe) corresponds to the improvement of disease prognosis. However, certain mutations such as the core promoter dual mutations (A1762G1764→T1762A1764), the codon 15 variants (C1858/ T1858) and the precore stop codon mutations (TGG→TAG) can affect the HBeAg expression. This has diagnostic and clinical implications. Besides that, the HBV can be grouped into eight genotypes (A to H). Moreover, genotypic subtypes and recombinants have been observed as well. Studies have observed that these can differ in their affiliations with the mutations above as well as with disease prognosis.
Hepatitis B Virus Genotypes and Mutations Affecting HBeAg Production: A Malaysian Perspective
Author
Abstrak
Jangkitan daripada virus hepatitis B (HBV) merupakan satu isu kesihatan besar sedunia. HBV merupakan suatu faktor terhadap peningkatan risiko penyakit hepar seperti sirosis dan juga dalam perkembangan penyakit kanser hepatosellular. Masalah ini terutamanya tersebar luas di rantau Asia-Pasifik, termasuk Malaysia. Semasa jangkitan, e antigen hepatitis B (HBeAg) adalah dihasilkan di dalam perumah. Antigen ini adalah satu penanda serologi yang penting di dalam diagnosis kesakitan kronik hepatitis B. Perubahan (seroconversion) kepada anti-bodi (anti-HBe) merupakan satu faktor terhadap kemajuan prognosis pengyakit. Tetapi terdapat beberapa mutasi seperti dwi mutasi ke atas promoter teras (core promoter double mutations) (A1762G1764→T1762A1764), varian kodon 15 (C1858/ T1858) dan mutasi pada kodon henti ke atas pra-teras (pre-core stop codon mutation) (TGG→TAG) yang boleh memberi kesan kepada pengeluaran HBeAg. Ini boleh mengakibatkan implikasi terhadap diagnosis dan klinikal penyakit tersebut. Selain itu, HBV juga boleh dibahagikan kepada lapan genotip (A ke H), subjenis genotip dan rekombinan juga ditemui. Kajian telah menunjukkan bahawa genotip berbezaan dari segi hubungan dengan mutasi-mutasi tersebut dan juga dengan prognosis penyakit hepatitis B.
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