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Basic Characteristics of Mutations
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Mutation Site
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G29R |
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Mutation Site Sentence
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These samples were also analysed for sequence variation in the precore region and were shown to have mutations at codon 28 (stop codon in place of tryptophan, by PMA and sequencing) and codon 29 (arginine in place of glycine, by sequencing only) in both pre- and post-transplant samples. |
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Mutation Level
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Amino acid level |
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Mutation Type
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Nonsynonymous substitution |
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Gene/Protein/Region
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PreC |
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Standardized Encoding Gene
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C
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Genotype/Subtype
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- |
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Viral Reference
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pHBV130
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Functional Impact and Mechanisms
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Disease
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Liver Diseases
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Immune
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- |
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Target Gene
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-
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Clinical and Epidemiological Correlations
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Clinical Information
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- |
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Treatment
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- |
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Location
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Italy;Japan |
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Literature Information
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PMID
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8834018
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Title
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Hepatitis B virus surface mutations associated with infection after liver transplantation
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Author
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Hawkins AE,Gilson RJ,Gilbert N,Wreghitt TG,Gray JJ,Ahlers-de Boer I,Tedder RS,Alexander GJ
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Journal
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Journal of hepatology
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Journal Info
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1996 Jan;24(1):8-14
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Abstract
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BACKGROUND/AIMS: Liver transplantation for chronic liver disease due to hepatitis B virus infection is associated with a high risk of graft infection, graft failure and death. Many centres restrict this procedure to those seronegative for HBV-DNA (by hybridisation assay) and use prophylactic polyclonal human hepatitis B specific immunoglobulin to prevent infection of the graft, despite the very high cost. METHODS: We describe three patients who underwent liver transplantation for chronic HBV-related disease in whom death was due to fibrosing cholestatic hepatitis following graft infection with hepatitis B virus, despite receiving hepatitis B specific immunoglobulin. Variation within the immunodominant a epitope of HBsAg was sought by analysis of hepatitis B virus sequences and the use of a point mutation assay, following amplification from serum by the polymerase chain reaction. RESULTS: Prior to transplantation, Cases 1 and 2 had mutations at nucleotide 1902 (codon 145), resulting in G-C substitutions, which persisted at a low level after transplantation. In Case 2 a second mutant type with a G-A substitution at nucleotide 1902, became the predominant viral type post transplant. Case 3 had exclusively wild type virus before and after transplantation. The emergence of mutant type virus in Case 2 may have occurred because of immune pressure exerted by high titre anti-HBs detectable for more than 7 months. Cases 1 and 3 received only brief courses of anti-HBs therapy. The mutant viral surface antigen was not detected by a monoclonal antibody-based assay, and therefore the choice of HBsAg assay for post-transplant monitoring of patients who receive liver grafts for hepatitis B virus disease is important. CONCLUSIONS: A search for mutations affecting the a determinant prior to liver transplantation for HBV-related liver disease may help to identify those at risk of failure of prophylaxis. Monoclonal antibodies specific to the codon 145-mutant surface antigen might prevent graft infection, but other mutations might then emerge.
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Sequence Data
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-
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