肝活检免疫组织化学检测中的阴性HBcAg是核苷（酸）类似物治

StephenW

J Cell Mol Med. 2017 Nov 29. doi: 10.1111/jcmm.13444. [Epub ahead of print]
Negative HBcAg in immunohistochemistry assay of liver biopsy is a predictive factor for the treatment of patients with nucleos(t)ide analogue therapy.Huang M1, Liu J1, Chow M2, Zhou X1, Han Z1, He Z3, Xue J1, Zhu Z4,5, Li X6, Xia J1.
Author information
1Department of Infectious Diseases, The Fifth Affiliated Hospital of Sun Yat-Sen University (SYSU), Zhuhai, Guangdong, China.2PGY IV, Department of General Surgery Rutgers, Robert Wood Johnson Medical School, Piscataway, NJ, USA.3School of Public Health, Sun Yat-sen University, Guangzhou, China.4Department of Medicine, Division of Regenerative Medicine, University of California, San Diego, School of Medicine, La Jolla, CA, USA.5Department of Stem Cell Biology and Regenerative Medicine, Cleveland Clinic, Lerner Research Institute, Cleveland, OH, USA.6Department of Infectious Diseases, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.

AbstractThe hepatitis B core antigen (HBcAg) is an important target for antiviral response in chronic hepatitis B (CHB) patients. However, the correlation between HBcAg in the hepatocyte nucleus and nucleos(t)ide analogue (NA) therapeutic response is unclear. We sought to evaluate the role of HBcAg by analysing liver biopsies for viral response in NA-naïve hepatitis B e antigen (HBeAg) positive (+) CHB patients via immunohistochemistry (IHC). A total of 48 HBcAg-negative (-) patients and 48 HBcAg (+) patients with matching baseline characteristics were retrospectively analysed for up to 288 weeks. Virological response (VR) rates of patients in the HBcAg (-) group were significantly higher at week 48 and 96 than the HBcAg (+) group (77.1% versus 45.8% at week 48, respectively, P = 0.002 and 95.3% versus 83.3% at week 96, respectively, P = 0.045). The serological negative conversion rate of HBeAg was significantly higher in the HBcAg (-) than in the HBcAg (+) group from week 96 to 288 (35.4 % versus 14.6% at week 96, respectively, P = 0.018; 60.4% versus 14.6%, respectively, P < 0.001 at week 144; 72.9% versus 35.4%, respectively, P < 0.001 at week 288). The cumulative frequencies of VR and lack of HBeAg were higher in the HBcAg (-) group (both P < 0.05). Binary logistic regression analysis showed that HBcAg (-) was the predictor for the lack of HBeAg (OR 4.482, 95% CI: 1.58-12.68). In summary, the absence of HBcAg in the hepatocyte nucleus could be an independent predictor for HBeAg seroconversion rates during NA-naïve treatment in HBeAg (+) CHB patients.


KEYWORDS: chronic hepatitis B; hepatitis B cor

StephenW

J Cell Mol Med。 2017年11月29日doi：10.1111 / jcmm.13444。 [电子版提前打印]
肝活检免疫组织化学检测中的阴性HBcAg是核苷（酸）类似物治疗患者治疗的预测因子。
Huang M1，Liu J1，Chow M2，Zhou X1，Han Z1，He Z3，Xue J1，Zhu Z4,5，Li X6，Xia J1。
作者信息

1
    中山大学附属第五医院感染科，广东珠海。
2
    PGY IV，美国新泽西州Piscataway罗伯特伍德约翰逊医学院罗格斯普通外科。
3
    广州中山大学公共卫生学院。
4
    加利福尼亚大学圣地亚哥分校医学系，美国加州拉霍亚医学院再生医学系。
五
    美国俄亥俄州克利夫兰勒纳研究所克利夫兰诊所干细胞生物学与再生医学系。
6
    中山大学附属第三医院感染科，广东广州。

抽象

乙型肝炎核心抗原（HBcAg）是慢性乙型肝炎（CHB）患者抗病毒应答的重要靶点。然而，肝细胞核中HBcAg与核苷（酸）类似物（NA）治疗反应之间的相关性尚不清楚。我们试图通过免疫组织化学（IHC）分析肝活检对NA-初免乙肝e抗原（HBeAg）阳性（+）CHB患者的病毒应答来评价HBcAg的作用。回顾性分析48例HBcAg阴性（ - ）患者和48例HBcAg（+）基线特征匹配的患者，最多288周。 HBcAg（ - ）组患者的病毒学应答率（VR）在48周和96周时显着高于HBcAg（+）组（48.1％分别为77.1％和45.8％，P = 0.002和95.3％，分别为83.3 ％在第96周，P = 0.045）。 HBcAg（ - ）组HBeAg血清学阴转率明显高于HBcAg组（+）组，96周至288周分别为35.4％和96.6％，P = 0.018; 60.4％比14.6％ ，第144周P <0.001;第288周分别为72.9％和35.4％，P <0.001）。 HBcAg（ - ）组的VR累积频率和HBeAg缺乏率均较高（均P <0.05）。二分类逻辑回归分析显示，HBcAg（ - ）是HBeAg缺乏的预测因子（OR 4.482,95％CI：1.58-12.68）。总之，肝细胞核中HBcAg的缺失可能是HBeAg（+）CHB患者无NA治疗期间HBeAg血清转换率的独立预测因子。
关键词：

慢性乙型肝炎;乙肝病毒