Association between HBx gene variation and severe disease development in Hepatitis B patients

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The majority of liver diseases such as cirrhosis and liver cancer in Indonesia are caused by the hepatitis B virus. People infected with hepatitis B virus will experience clinical conditions with a varying spectrum, including acute, chronic, cirrhosis, fulminant and liver cancer. This condition is influenced by the characteristics of the virus and the infected individual. Several studies examined the correlation between the clinical condition of hepatitis B virus infected patients and the molecular characteristics of the virus related to genetic changes or mutations that emerged. A high frequency of mutations in hepatitis B virus gene is often found in patients at an advanced stage, for example in conditions of cirrhosis or liver cancer.

A study entitled The Association Between HBx Gene Variation and the Development of Severe Liver Disease in Patients infected with Hepatitis B virus in Indonesia has reported a genetic change in the hepatitis B virus gene encoding protein X which plays an important role in the development of severe liver disease. The study included 114 patients infected with the hepatitis B virus and the frequency of mutations in gene X was compared among viral variants acquired from patients with chronic hepatitis, cirrhosis and liver cancer. The frequency of mutations in the Basal Core Promoter (BCP) region in gene X is significantly greater in advanced liver disease than in chronic hepatitis.

Furthermore, the dual mutation K130M / V131I and the triple mutation N88V / K130M / V131I were associated with 2.5 times the high risk of advanced liver disease. The finding of a correlation between multiple mutations in gene X of hepatitis B virus and the severity of hepatitis B virus is because these mutations cause the virus to escape from the immune system of individuals who are infected with the hepatitis B virus. Thus, it is important to see pattern of genetic change or mutations of Hepatitis B virus variants to maximize treatment efforts. Furthermore, knowing the mutation pattern can also be used to create strategies to prevent the transmission of these virus variants.

Author: Laura Navika Yamani, S.Si., M.Si., Ph.D

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