Detection and Molecular Characterization of Hepatitis B virus (X gene) in Sudanese Patients with Chronic Hepatitis B

Abstract

Background: HBx gene mutations may have a role in the progression of liver disease from chronic infection to liver cirrhosis and/or hepatocellular carcinoma. These mutations affect the biological functions of HBx protein, which may influence the development of liver diseases. The aim of this study was to detect and characterizeHepatitis B virus X gene in Sudanese patients with chronic Hepatitis B, describe the variability of this gene among patients and find out the prevalent genotypes and their association with HBV infection outcome. Methods: A total of 185 patients positive for HBV infection (88 asymptomatic carriers, 39 chronic hepatitis, 38 liver cirrhosis and 20 with hepatocellular carcinoma) were recruited to participate in this study.DNA was extracted from serum samples using chelex method. HBx DNA of nineteen patients was successfully amplified using nested PCR. HBx gene positive products were sequenced and genotyped. Nucleotide and amino acid variability were determined. Results: HBx30, HBx127, HBx130 and HBx131 were the most detected mutations in HCC and LC patients. Double mutations K130M/V131I and F30L/V mutation were associated with high risk of LC and HCC development. Our study found that the most prevalent genotype was genotype D (47.4%), followed by E (42.1%) and A (10.5%). Patients with genotype E had ALT elevation exceeding those with genotype D and A. HBx30, HBx130 and HBx131 mutations were associated with liver disease progression from chronic hepatitis to cirrhosis and hepatocellular carcinoma. Conlusion: In conclusion, HBx30, HBx130 and HBx131 mutations may be useful markers for predicting the clinical course of patients with chronic hepatitis B