Hepatitis B virus core promoter and precore mutations and their relatedness to genotypes and disease pathogenesis

Despite the successful vaccination programme worldwide, Hepatitis B virus infection remains a global problem. Infection rate in developing countries is higher in comparison to the developed countries. Core promoter region (nts.1591-1822) plays a very important role in HBV replication, morphogenesis and pathogenesis, whereas the precore region (nts.1814 to 1901) contains the start site for synthesis of pregenomic RNA, direct repeat 1 (DR1), and RNA encapsidation signal (ε) region. Mutations in both core promoter and precore regions seem to represent desperate attempts by the virus to escape from host immune surveillance which results in the evolution of new mutated strain which may have altered pathogenicity. It has been demonstrated by many studies that core promoter and precore regions of HBV have direct role in disease pathogenesis. So, in the present review we try to conclude the observations by different groups from all over the world with respect to the influence of core promoter and precore mutations on the HBV-induced disease progression.