Hepatitis B virus (HBV) X gene mutations and their association with liver disease progression in HBV-infected patients
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Ahmed A. Al-Qahtani1,2, Mashael R. Al-Anazi1, Nyla Nazir1, Rohit Ghai3, Ayman A. Abdo4,8, Faisal M. Sanai5,8, Waleed K. Al-Hamoudi4,8, Khalid A. Alswat4,8, Hamad I. Al-Ashgar6, Mohammed Q. Khan6, Ali Albenmousa7, Damian Dela Cruz1, Marie Fe F. Bohol1 and Mohammed N. Al-Ahdal1,2
1Department of Infection and Immunity, Research Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
2Department of Microbiology and Immunology, Alfaisal University School of Medicine, Riyadh, Saudi Arabia
3Institute of Hydrobiology, Department of Aquatic Microbial Ecology, Biology Centre of the Academy of Sciences of the Czech Republic, České Budějovice, Czech Republic
4Section of Gastroenterology, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
5Gastroenterology Unit, Department of Medicine, King Abdulaziz Medical City, Jeddah, Saudi Arabia
6Gastroenterology Unit, Department of Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
7Department of Gastroenterology, Prince Sultan Medical Military City, Riyadh, Saudi Arabia
8Liver Disease Research Center, King Saud University, Riyadh, Saudi Arabia
Ahmed A. Al-Qahtani, email: [email protected]
Keywords: HCC; hepatitis; cirrhosis; HBx; mutations
Received: August 03, 2017 Accepted: October 17, 2017 Published: November 06, 2017
Hepatitis B virus (HBV) is one of the most widespread human pathogens causing chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma (HCC). This study investigated the clinical impact of single and combinational mutations in HBx gene on the pathogenesis of HCC during progressive stages of liver disease. The patients were categorized into inactive HBV carriers, active carriers, cirrhosis and HCC groups based on disease severity. Male sex, age > 50 years, and high serum alanine aminotransferase level were associated with risk of progressive liver disease. I127T, V131I, and F132Y/I/R mutations showed a significant increasing trend associated with the disease progression to HCC. H94Y and K130M mutations were also significantly associated with severe liver disease. One double mutation (K130M+V131I) and two triple mutations (I127T+K130M+V131L and K130M+V131I+F132Y) were observed, with significant rising prevalence through progressive clinical phases of liver disease to HCC. Several single and combinational mutations in HBx correlating with severity and progressive clinical phases of HBV infection were identified. The mutational combinations may have a synergistic effect in accelerating the progression to HCC. These specific patterns of HBx mutations can be useful in predicting the clinical outcome of HBV-infected patients and may serve as early markers of high risk of developing HCC.
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