Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSPREUTER, TaniaGOMES-GOUVEA, Michele SoaresCHUFFI, SamiraDUQUE, Ulisses HorstPERINI, WaltesiaAZEVEDO, Raymundo SoaresPINHO, Joao Renato RebelloLEWIS-XIMENEZ, Lia L.VILLAR, Livia MeloESPUL, Carlos AlbertoPUJOL, Flor H.ROMAN, Sonia2024-02-152024-02-152023VIRUSES-BASEL, v.15, n.12, article ID 2339, 11p, 2023https://observatorio.fm.usp.br/handle/OPI/58038In Brazil, hepatitis B virus endemicity is low, moderate, or high in some areas, such as Espirito 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 Espirito 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 < 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 < 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 < 0.001). Interestingly, HBV DNA was lower than 2000 IU/mL especially when both BCP/PC mutations were present (p < 0.001) or when only PC mutations were detected (p = 0.047), reinforcing their role in viral replication.engopenAccesschronic hepatitis BHBVpre core mutationsbasal core promoter mutationsBCP and PC variantsmutationsbrazilarticleCopyright MDPI10.3390/v15122339Virology1999-4915