Comparative Analysis Of Hepatitis B Virus(HBV) Pre-S Deletion In Chronic HBV-infected Patients With Different Illness Categories

Objective: To investigate the clinical and epidemiological characteristics of pre-S deletion in chronically HBV-infected patients with different illness categories.Methods: pre-S gene(nt2848-154) from 146 patients with chronic hepatitis B(CHB)(CHB group), 111 patients with liver cirrhosis(LC)(LC group),146 patients with acute-on-chronic liver failure(ACLF)(ALCF group) and 136 patients with hepatocellular carcinoma(HCC)(HCC group) were amplified by nested PCR and sequenced. Comparative analysis was performed on the occurrence rate, hotspot and fragment length of pre-S deletion mutation of the 4different groups. Results: Among the four groups of patients, the overall pre-S deletion mutation rates of LC group and HCC group were significantly higher than that of CHB group(26.1% vs 15.8%, P = 0.040; 34.6% vs 15.8%, P < 0.001);pre-S1 deletion mutation rate of LC group were significantly higher than that of CHB group(17.1% vs 4.8%, P = 0.001); pre-S2 deletion mutation rate of HCC group were significantly higher than that of CHB group(19.1% vs. 4.8%, P <0.001). The hotspots of deletions varied in different groups, nt 3031-3215(30.4%)and nt 24-57(30.4%) in CHB group; nt 2849-2866(55.2%) and nt 5-55(31.0%) in LC group; nt2849-2866(28.6%) and nt1-54(25.7%) in ACLF group;and nt 5-55(57.4%) and nt 2849-2866(12.8%) in HCC group. There was no difference in deletion fragment length among the 4 groups.Conclusion: Among the patients with chronic HBV infection, the overall pre-S deletion mutation rates increase with the disease progression. The pre-S1 deletion mutation was significantly increased in LC patients, while the pre-S2 deletion mutation was significantly increased in HCC patients. HBV pre-S deletion might be a driving factor for advanced liver diseases in chronic HBV infection.