an indicator of active viral replication and high levels of infecOur purpose was to ascertain if mutations of the pretivity. HBeAg negativity and hepatitis B e antigen antibody core region of the hepatitis B virus genome, in particular (anti-HBe) positivity are used as markers of decreased viral the 1896 stop codon mutation, are responsible for the replication and resolution of inflammation. 3 Precore muta-95% hepatitis B e antigen (HBeAg)-negativity rate in tions that abolish HBeAg expression without a concomitant southern African black adult carriers. Hepatitis B virus decrease in viral replication have, however, been described. (HBV) DNA was extracted from the serum of 57 asymp-A guanine (G) to adenine (A) transition at nucleotide 1896 of tomatic carriers (42 HBeAg-negative; 15 HBeAg-posithe precore region, resulting in a translational stop codon, is tive), the precore region was amplified using the polythe mutation that most often prevents HBeAg expression. 4,5 merase chain reaction (PCR), and sequenced. SixOther stop codon, translation-initiation codon, or frameshift carriers (14.6%) had mutations known to prevent HBeAg mutations are detected rarely. 5-9 synthesis: 4 involved the precore initiation codon (1814),The HBeAg-minus mutation caused by the 1896 transition and one created a stop codon at 1874. The 1896 mutation is present in almost all patients with anti-HBe-positive, occurred alone in one carrier only (2.4%). The infre-HBV DNA-positive chronic hepatitis in Italy, 8,10 Greece, 4 quency of the 1896 mutation can be explained by the Bulgaria, 11 Spain, 12 and Japan. 5 This mutation occurs less high prevalence (70%) of the adw subtype in the carriers frequently in North America, 13 France, 14-16 the United Kingstudied. Inter alia, adw differs from ayw in that codon dom, 17 and China. 18,19
is comprised of CCC instead of CCT. The presenceAlthough a few black Africans have been included in invesof C instead of T in position 1858 precludes the G-to-A tigations conducted in countries to which they have mimutation at 1896 because the coexistence of these two grated, 20-22 the prevalence of precore mutants of HBV in this mutations would destabilize the stem-loop structure of population has not been formally determined. the RNA encapsidation signal, a finding confirmed by HBV infection is hyperendemic in southern African blacks. our observation that the CCC polymorphism and the A feature of chronic carriers of HBV in this population is 1896 mutation were mutually exclusive. Ten HBeAg-negthat only 5% are still HBeAg-positive by the time they reach ative carriers (24%) had a missense mutation at position adulthood, 23 compared with higher rates of 40% or more in 1862 in the bulge of the RNA encapsidation signal, which other hyperendemic areas of the world. 24 The reason for the may possibly affect HBeAg expression by interfering high rate of HBeAg negativity is not known. Thus, the purwith either priming of reverse transcription or signal pose of this study was to determine whether mutations in peptide cleav...