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The pathogenesis of the carcinogenesis is not fully understood. Viral proteins such as the X protein and the truncated middle S protein have been implicated to be transactivators. In order to investigate whether any mutations within relevant parts of the hepatitis B virus (HBV) genome could be associated with the development of HCC, the genomes of 16 HBV strains from chronic HBV carriers with HCC were studied. Serum samples were subjected to PCR and the HBV DNA sequenced subsequently. Genotypes A\u2013D were represented. The sequence analysis showed that an especially high proportion, 50% (CI 95%, 25\u201375%), of the patients with HCC carried HBV mutants with deletions or insertions in the N\u2010terminal half of the pre\u2010S2 region or had a point mutation in the start codon of pre\u2010S2 compared with controls with chronic HBV infection, 21% (CI 95%, 3\u201339%). A high proportion (69%) also had mutations at position 1762 (A\u2009\u2192\u2009T) and\/or 1764 (G\u2009\u2192\u2009A) in the core promoter region, but the proportion of core promoter mutations was no different from what was found in a control group of HBV carriers without HCC (68%). The pre\u2010S2 variants, which involve deletions of immunogenic regions, may have a survival advantage as they are mostly found in long\u2010standing HBV infection. There were no other mutations found frequently within the region coding for the X protein. J. Med. Virol. 71:18\u201323, 2003. \u00a9 2003 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/jmv.10458","type":"journal-article","created":{"date-parts":[[2003,7,9]],"date-time":"2003-07-09T10:06:37Z","timestamp":1057745197000},"page":"18-23","source":"Crossref","is-referenced-by-count":30,"title":["Mutations within the hepatitis B virus genome among chronic hepatitis B patients with hepatocellular 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