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World J Gastroenterol. Sep 21, 2008; 14(35): 5448-5453
Published online Sep 21, 2008. doi: 10.3748/wjg.14.5448
Clinical, virologic and phylogenetic features of hepatitis B infection in Iranian patients
Golnaz Bahramali, Majid Sadeghizadeh, Samad Amini-Bavil-Olyaee, Seyed-Moayed Alavian, Abbas Behzad-Behbahani, Ahmad Adeli, Mohammad-Reza Aghasadeghi, Safieh Amini, Fereidoun Mahboudi
Golnaz Bahramali, Majid Sadeghizadeh, Department of Genetics, Faculty of Basic Sciences, Tarbiat Modares University, Tehran 14115-175, Iran
Samad Amini-Bavil-Olyaee, Fereidoun Mahboudi, Ahmad Adeli, Biotechnology Department, Pasteur Institute of Iran, Tehran 13164, Iran
Mohammad-Reza Aghasadeghi, Safieh Amini, Hepatitis and HIV Department, Pasteur Institute of Iran, Tehran 13164, Iran
Seyed-Moayed Alavian, Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Tehran Hepatitis Center, Tehran 14155-3651, Iran
Abbas Behzad-Behbahani, Medical Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz 7143914693, Iran
Author contributions: Bahramali G performed the research; Amini-Bavil-Olyaee S and Sadeghizadeh M designed the research; Alavian SM and Behzad-Behbahani A did the sample collection; Mahboudi F, Adeli A, Aghasedeghi MR, Amini S contributed to the project; Amini-Bavil-Olyaee S and Bahramali G analyzed the data and wrote the manuscript; Sadeghizadeh M provided financial support; Bahramali G and Amini-Bavil-Olyaee S contributed equally to this work.
Corresponding to: Dr. Majid Sadeghizadeh, PhD, Department of Genetics, Faculty of Basic Sciences, Tarbiat Modares University, Tehran 14115-175, Iran. sadeghma@modares.ac.ir
Telephone: +98-218-2884409 Fax: +98-218-2883463
Received: June 15, 2008
Revised: July 30, 2008
Accepted: August 6, 2008
Published online: September 21, 2008

AIM: To characterize the clinical, serologic and virologic features of hepatitis B virus (HBV) infection in Iranian patients with different stages of liver disease.

METHODS: Sixty two patients comprising of 12 inactive carriers, 30 chronic hepatitis patients, 13 patients with liver cirrhosis and 7 patients with hepatocellular carcinoma (HCC) were enrolled in the study. The HBV S, C and basal core promoter (BCP) regions were amplified and sequenced, and the clinical, serologic, phylogenetic and virologic characteristics were investigated.

RESULTS: The study group consisted of 16 HBeAg-positive and 46 HBeAg-negative patients. Anti-HBe-positive patients were older and had higher levels of ALT, ASL and bilirubin compared to HBeAg-positive patients. Phylogenetic analysis revealed that all patients were infected with genotype D (mostly ayw2). The G1896A precore (PC) mutant was detected in 58.1% patients. HBeAg-negative patients showed a higher rate of PC mutant compared to HBeAg-positive patients (χ2 = 9.682, P = 0.003). The majority of patients with HCC were HBeAg-negative and were infected with PC mutant variants. There was no significant difference in the occurrence of BCP mutation between the two groups, while the rate of BCP plus PC mutants was higher in HBeAg-negative patients (χ2 = 4.308, P = 0.04). In the HBV S region, the genetic variability was low, and the marked substitution was P120T/S, with a rate of 9.7% (n = 6).

CONCLUSION: In conclusion, HBV/D is the predominant genotype in Iran, and the nucleotide variability in the BCP and PC regions may play a role in HBV disease outcome in HBeAg-negative patients.

Keywords: Hepatitis B virus, Clinical and virologic features, Genetic variability, Phylogenetic analysis