10779/rcsi.10780100.v1 Maimuna E. Mendy Maimuna E. Mendy Steve Kaye Steve Kaye Emilie Le Roux Emilie Le Roux Gregory D. Kirk Gregory D. Kirk Adam Jeng-Barry Adam Jeng-Barry Samuel McConkey Samuel McConkey Matthew Cotten Matthew Cotten Mark H. Kuniholm Mark H. Kuniholm Aleksandra Leligdowicz Aleksandra Leligdowicz Pierre Hainaut Pierre Hainaut Sarah Rowland-Jones Sarah Rowland-Jones Hilton Whittle Hilton Whittle Application of a novel, rapid, and sensitive oligonucleotide ligation assay for detection of cancer-predicting mutations in the precore and basal core promoter of hepatitis B virus. Royal College of Surgeons in Ireland 2019 Carcinoma Hepatocellular Gambia Hepatitis B Core Antigens Hepatitis B virus Humans Ligation Liver Liver Cirrhosis Oligonucleotide Probes Point Mutation Promoter Regions Genetic Severity of Illness Index Statistics as Topic 2019-11-22 16:09:09 Journal contribution https://repository.rcsi.com/articles/journal_contribution/Application_of_a_novel_rapid_and_sensitive_oligonucleotide_ligation_assay_for_detection_of_cancer-predicting_mutations_in_the_precore_and_basal_core_promoter_of_hepatitis_B_virus_/10780100 <p>Hepatocellular carcinoma (HCC) and cirrhosis are important causes of mortality worldwide. Persistent hepatitis B virus (HBV) infection is a major cause of these diseases. Double mutations in the basal core promoter (BCP) (A1762T and G1764A) and precore (pre-C) (G1896A) regions of the virus are associated with progression to HCC. The current study is aimed at developing a simple method for screening and detecting BCP and pre-C mutations in HBV carriers. We have developed and validated an oligonucleotide ligation assay (OLA) to detect point mutations in the HBV core gene. We have applied OLA methods to samples from HBV-infected carriers recruited from the Gambia Liver Cancer Study (GLCS) comprising asymptomatic HBsAg carriers, patients with cirrhosis, and patients with HCC. We observed an 89.3% and 95.8% concordance between the OLA and DNA sequencing for BCP and pre-C mutations, respectively. OLA detected the mutations in single-strain infections and in infections with mixtures of wild-type and mutant viruses under conditions where sequencing detected only the single dominant strains. BCP mutations were detected in 75.7% of patients with advanced liver disease (cirrhosis/HCC) compared to 47.6% of asymptomatic carriers, while pre-C mutations were detected in 34.5% of advanced liver disease patients and in 47.6% of asymptomatic HBsAg carriers. There was a significant association between the presence of BCP mutations and advanced liver disease. In conclusion, OLA is a simple, economical, and reliable assay for detection of pre-C and BCP mutations. Its application can lead to improvement in diagnosis and clinical care in regions where HBV is endemic.</p>