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Spontaneous mutations of hepatitis B virus (HBV) could influence the severity of liver disease. Since the basal core promoter (BCP) and the precore (Pc) regions are important for viral replication, these regions were examined for naturally occurring mutations and were correlated with the genotype, e antigen status, and severity of liver disease. In 82 patients with histologically confirmed chronic hepatitis B, the BCP and Pc regions were sequenced and aligned with known wild‐type sequences. Sequence based HBV genotyping was done and HBV DNA was quantified. Thirty‐three (40%) patients had decompensated chronic liver disease and the remaining patients had chronic hepatitis B. Forty‐six (56%) patients were HBeAg positive. HBV genotype A was found in 28%, D in 65%, and B/C in 7.3%. The Pc G1896A mutation was more common in HBeAg‐negative (33% vs. 2%, P < 0.01) patients and was genotype …