Substitution in transcription-regulating site of pre-S1 region is associated with viral regulation of hepatitis B virus

The influence of HBV mutation for clinical course has been shown by many evidences. The various functions of L protein raise the possibility that the mutations in the pre-S1 promoter region might affect the expression of L protein and subsequently change the viral dynamics and prognosis. To examine this hypothesis, in this study, we investigated the relevance between mutations in pre-S1 promotor region of HBV and viral prognosis and kinetics using clinical samples and cultured cell line. our current study raises a novel possible scenario in which the mutations in the promoter region of Pre-S1, especially in Sp1 region reduce the expression of L protein, regulate viral kinetics, leading to low viral load and less severe disease in chronic HBV infection.