{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:48:30Z","timestamp":1789541310802,"version":"build-2803163510"},"reference-count":24,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T00:00:00Z","timestamp":1701216000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"LIMHCFMUSP (Laborat\u00f3rios de Investiga\u00e7\u00e3o M\u00e9dica do Hospital das Cl\u00ednicas da Faculdade de Medicina da USP)"},{"name":"Funda\u00e7\u00e3o Faculdade de Medicina da USP e Laboratorio Cl\u00ednico do Hospital Israelita Albert Einstein"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>In Brazil, hepatitis B virus endemicity is low, moderate, or high in some areas, such as Esp\u00edrito Santo State in the southeast region. In this study, we intend to characterize the basal core promoter (BCP) and pre-core region (PC) variants and their association with clinical\/epidemiological disease patterns in patients infected with genotypes A and D. The study included 116 chronic hepatitis B patients from Esp\u00edrito Santo State, Southeast Brazil, infected with genotypes A and D. Basal core promoter (BCP) and pre-core mutations were analyzed in these patients. The frequency of BCP and PC mutations was compared with age, HBeAg status, HBV genotype and subgenotype, HBV-DNA level, clinical classification, and transmission route. HBeAg-negative status was found in 101 (87.1%) patients: 87 (75.0%) were infected with genotype A (A1 = 85; A2 = 2) and 29 (25.0%) were infected with genotype D (D3 = 24; D4 = 3; D2 = 2). BCP + PC variants altogether were more frequent (48.1%) in genotype D than in genotype A strains (6.0%) (p &lt; 0.001). When this evaluation was performed considering the cases that presented only the A1762T and\/or G1764A (BCP) mutations, it was observed that the frequency was higher in genotype A (67.5%) compared to genotype D (7.4%) (p &lt; 0.001). On the other hand, considering the samples with mutations only in positions G1896A and\/or G1899A (PC), the frequency was higher in genotype D (75.8%) than in genotype A (6.9%) (p &lt; 0.001). Interestingly, HBV DNA was lower than 2000 IU\/mL especially when both BCP\/PC mutations were present (p &lt; 0.001) or when only PC mutations were detected (p = 0.047), reinforcing their role in viral replication.<\/jats:p>","DOI":"10.3390\/v15122339","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T03:48:24Z","timestamp":1701229704000},"page":"2339","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Core Promoter and Pre-Core Variants of the Hepatitis B Virus (HBV) Are Frequent in Chronic Hepatitis B HBeAg-Negative Patients Infected by Genotypes A and D"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2176-5603","authenticated-orcid":false,"given":"Tania","family":"Reuter","sequence":"first","affiliation":[{"name":"Internal Medicine Department, Health Science Center, University Hospital Cassiano Ant\u00f4nio de Moraes, Federal University of Espirito Santo, Vit\u00f3ria 29041-295, ES, Brazil"},{"name":"LIM-07, Institute of Tropical Medicine, Department of Gastroenterology, School of Medicine, University of Sao Paulo, S\u00e3o Paulo 05403-907, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5932-2360","authenticated-orcid":false,"given":"Michele Soares","family":"Gomes-Gouvea","sequence":"additional","affiliation":[{"name":"LIM-07, Institute of Tropical Medicine, Department of Gastroenterology, School of Medicine, University of Sao Paulo, S\u00e3o Paulo 05403-907, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samira","family":"Chuffi","sequence":"additional","affiliation":[{"name":"LIM-07, Institute of Tropical Medicine, Department of Gastroenterology, School of Medicine, University of Sao Paulo, S\u00e3o Paulo 05403-907, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulisses Horst","family":"Duque","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Health Science Center, University Hospital Cassiano Ant\u00f4nio de Moraes, Federal University of Espirito Santo, Vit\u00f3ria 29041-295, ES, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waltesia","family":"Perini","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Health Science Center, University Hospital Cassiano Ant\u00f4nio de Moraes, Federal University of Espirito Santo, Vit\u00f3ria 29041-295, ES, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0660-2371","authenticated-orcid":false,"given":"Raymundo Soares","family":"Azevedo","sequence":"additional","affiliation":[{"name":"Department of Pathology, School of Medicine, University of Sao Paulo, S\u00e3o Paulo 01246-903, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Renato Rebello","family":"Pinho","sequence":"additional","affiliation":[{"name":"LIM-07, Institute of Tropical Medicine, Department of Gastroenterology, School of Medicine, University of Sao Paulo, S\u00e3o Paulo 05403-907, SP, Brazil"},{"name":"Clinical Laboratory, Hospital Israelita Albert Einstein, S\u00e3o Paulo 05652-900, SP, Brazil"},{"name":"LIM-03, Central Laboratories Division, Clinics Hospital, School of Medicine, University of Sao Paulo, S\u00e3o Paulo 05403-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Lago, B.V., Esp\u00edrito Santo, M.P., Costa, V.D., Marques, V.A., Villar, L.M., Lewis-Ximenez, L.L., Lampe, E., and Mello, F.C.A. 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