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World J Gastroenterol. Jan 14, 2014; 20(2): 460-467
Published online Jan 14, 2014. doi: 10.3748/wjg.v20.i2.460
Hepatitis B virus mutations related to liver disease progression of Korean patients
Bum-Joon Kim
Bum-Joon Kim, Department of Biomedical Sciences, Microbiology and Immunology, Liver Research Institute, and Cancer Research Institute, College of Medicine, Seoul National University, Seoul 110-799, South Korea
Author contributions: Kim BJ solely contributed to this paper.
Supported by A National Research Foundation of Korea grant funded by the Korean government (MEST), No. 2013005810
Correspondence to: Bum-Joon Kim, PhD, Department of Biomedical Sciences, Microbiology and Immunology, Liver Research Institute, and Cancer Research Institute, College of Medicine, Seoul National University, 28 Yongon-dong, Chongno-gu, Seoul 110-799, South Korea. kbumjoon@snu.ac.kr
Telephone: +82-2-7408316 Fax: +82-2-7430881
Received: September 24, 2013
Revised: October 24, 2013
Accepted: November 3, 2013
Published online: January 14, 2014
Abstract

Hepatitis B virus (HBV) infection is a global health problem and more than 350 million people worldwide are chronic carriers of the virus. Despite the recent dramatic decline in HBV chronic patients through successful programs of hepatitis B surface antigen vaccination, South Korea is still recognized as an endemic area of HBV infection. HBV infections in South Korea exhibit several distinct features in epidemiologic and clinical aspects. In this review paper, we summarize the distinct HBV mutation patterns related to clinical severity and the molecular epidemiologic traits in Korean chronic patients based on previous reports. Generally, several lines of evidence, including our previous results, have led to the conclusion that a combination of the exclusive predominance of genotype C2, which is prone to mutations, the high prevalence of basal core promoter double mutations, and the presence of distinct immune responses against HBV proteins in the Korean population may generate the distinct HBV variants rarely or not encountered in other areas, which results in distinct clinical manifestations in Korean chronic patients. This may provide a novel insight into the relationships between clinical severity, HBV genotype distribution, and HBV naturally occurring variants.

Keywords: Hepatitis B virus, Mutation, South Korea, Hepatocellular carcinoma, Genotype C2

Core tip: In this review paper, we summarize the distinct hepatitis B virus (HBV) mutation patterns related to clinical severity and the molecular epidemiologic traits in Korean chronic patients based on previous reports. Generally, several lines of evidence have led to the conclusion that a combination of the exclusive predominance of genotype C2, which is prone to mutations, the high prevalence of basal core promoter double mutations, and the presence of distinct immune responses against HBV proteins in the Korean population may generate the distinct HBV variants rarely or not encountered in other areas, which results in distinct clinical manifestations in Korean chronic patients.