Objective To study the association of hepatitis B virus (HBV) basic core promoter (BCP) /precore (Pre C) mutations with the HBeAg, HBV DNA level and the progression of liver disease.Methods 283 untreated HBV patients were divided into 2 groups: chronic hepatitis B group with 185 patients (CHB, 185) and liver cirrhosis group with 98 patients (LC, 98) .HBV BCP and PreC mutations and genotypes were determined by direct sequencing.Results Precore (A1896) mutation was higher in HBeAg negative than that in HBeAg positive patients in CHB [44.6% (37/83) vs 21.6% (22/102) , χ2=11.154, P=0.001] and LC [43.4% (23/53) vs 17.0% (8/47) , χ2=8.101, P=0.004], respectively.Among HBeAg positive patients, BCP dual mutations (T1762/A1764) were more common in LC patients than that in CHB patients [89.4% (42/47) vs 70.6% (72/102) , χ2=6.310, P=0.012].In univariant analysis, age (≥45 years) (χ2=27.861, P<0.001) , BCP T1762/A1764 mutations (χ2=8.675, P=0.003) and HBV DNA (≥105 copies/ml) (χ2=20.499, P<0.001) were associated with the progression of LC.Multivariate logistic regression analysis (adjusted for age and gender) revealed that BCP T1762/A1764 mutations (OR=3.260, 95% CI:1.401～7.586;wald=7.517, P=0.006) and HBV DNA (≥105 copies/ml) (OR=4.640, 95% CI:2.331～9.237;wald=19.089, P<0.001) were independently associated with the LC development.Conclusion PreC mutation (A1896) was associated with HBeAg loss.Age (≥45years) , T1762/A1764 mutations, HBV DNA (≥105 copies/ml) were risk factors for LC progression.
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