ABSTRACT
In sub-Saharan Africa a causal relationship has been established between hepatitis B
virus (HBV) infection and membranous nephropathy (MN), especially in Black children.
The most common method of treatment is interferon therapy, which is however, only
effective in 30-40% of patients. The reason for this is unclear. The objective of this pilot
study was to determine whether mutations in the complete surface gene of HBV isolated
from Black children with HBV-associated MN before, during and after treatment with
interferon, had any effect on treatment response and vice versa. HBV DNA was extracted
from the serum of a responder, reverter and non-responder patient before, during (4 and
16 weeks) and after (40 weeks) IFN treatment. The preS1/preS2/S region was amplified
and cloned, and the clones sequenced. Sequence analyses revealed the preS2 region to be
the most variable in the reverter and non-responder and HBsAg was the most variable in
the non-responder. Phylogenetic analysis showed that the viral population dynamics
between the responder strains and the reverter/non-responder strains differed as a result
of various mutations found within the surface gene. Thus the presence of mutations in
preS2 and HBsAg of the non-responding patients may carry predictive markers for nonresponse
but further investigation would be needed to conclusively prove this.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/5263 |
| Date | 06 August 2008 |
| Creators | Gous, Natasha Myrna |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | 3298653 bytes, application/pdf, application/pdf |
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