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Gut Liver. 2017 Feb 17. doi: 10.5009/gnl16148. [Epub ahead of print]
Expression of Hepatocyte Hepatitis B Core Antigen and Hepatitis B Surface Antigen as a Marker in the Management of Chronic Hepatitis B Patients.Yim SY1, Kim TH1, Jun SS1, Kim ES1, Keum B1, Seo YS1, Yim HJ1, Jeen YT1, Chun HJ1, Lee HS1, Um SH1, Kim CD1, Won NH2, Ryu HS1.
Author information
- 1Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
- 2Department of Pathology, Korea University College of Medicine, Seoul, Korea.
AbstractBackground/Aims: We aimed to clarify the association of HBsAg/HBcAg with the disease status and treatment response in patients with chronic hepatitis B (CHB).
Methods: We investigated 171 biopsy-proven entecavir-treated CHB patients (109 HBeAg-positive, 62 HBeAg-negative). HBcAg expression was positive when ≥10% of hepatocytes stained, and classified into nuclear, mixed, and cytoplasmic patterns. HBsAg expressions were intracytoplasmic (diffuse, globular, and submembranous) and membranous. The histologic activity index (HAI) and fibrosis stage followed Ishak system.
Results: In HBeAg-positive patients, older age, increased HAI score, advanced fibrosis, and reduced viral load were observed when HBcAg expression shifted from nucleus to cytoplasm in HBcAg-positive patients, and HBsAg expression from non-submembranous to submembranous in HBcAg-negative patients (all, p<0.05). In HBeAg-negative patients, only intracytoplasmic HBsAg expression patterns had clinical relevance with decreased ALT levels and viremia. In HBeAg-positive patients without favorable predictors of virologic response, negative HBcAg and membranous HBsAg expression predicted greater virologic response (both, p<0.05). The probability of HBeAg seroclearance was higher in patients with increased HAI or lacking HBcAg expression (both, p<0.05). Higher serum HBsAg levels and hepatocyte HBcAg positivity were associated with reduced serum HBsAg during first and post-first year treatment, respectively (both, p<0.05).
Conclusions: Hepatocyte HBcAg/HBsAg expression is a good marker for disease status and predicting treatment response.
KEYWORDS: Hepatitis B core antigens; Hepatitis B surface antigens; Hepatitis B, chronic; Histologic activity index
PMID:28208002DOI:10.5009/gnl16148
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