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Abstract
Background: Mutations in the precore region and core promoter were compared between patients with acute and chronic hepatitis B. Methods: There were 69 patients with acute self‐limited hepatitis B and 210 with chronic hepatitis B who had been followed for >15 years. The hepatitis B virus (HBV) of genotypes A, B and C was detected in 14 (23%), 8 (13%) and 28 (45%) of the patients with acute self‐limited hepatitis, respectively, in contrast to 11 (5%), 25 (12%) and 167 (80%) of those with chronic hepatitis. Results: At presentation, hepatitis B e antigen (HBeAg) in serum was the more common (82% versus 65%, P < 0.05), and the wild‐type sequences of the precore region (100% versus 74%, P < 0.001) and core promoter (88% versus 36%, P < 0.00001) were more frequent in the 50 patients with acute self‐limited hepatitis than the 203 patients with chronic hepatitis B who were infected with HBV of genotype A, B or C. Wild‐types of both the precore region and core promoter persisted in acute self‐limited hepatitis, while they decreased from 28% to 10% in chronic hepatitis over the course of >15 years. Conclusion: HBV with the wild‐type sequences of the precore region and core promoter prevails in patients with acute self‐limited hepatitis, unlike in patients with chronic hepatitis.