Mutations identified in the HBV genomes from mothers and infants are illustrated. (C)The horizontal line represents the HBV nucleotide sequence of the reference genome (11). (A) The four open reading frames (ORF) are depicted in open bars. Lines within these bars represent mutations resulting in amino acid changes in the infant with fulminant disease. (B) Black bars in the middle indicate enhancer and promotor regions (GRE: Glucocorticoid response element, ENH I-XP: enhancer I and X promotor, ENH II-CP: enhancer II and core promotor, ε: pregenome RNA encapsidation signal epsilon, SP I: surface promotor I, SP II: surface promotor II).