Hepatology
Original article
Quantification of large and middle proteins of hepatitis B virus surface antigen (HBsAg) as a novel tool for the identification of inactive HBV carriers
Maria Pfefferkorn1, Stephan Böhm2, Tina Schott1, Danilo Deichsel1, Corinna M Bremer3, Kathrin Schröder3, Wolfram H Gerlich3, Dieter Glebe3, Thomas Berg1, Florian van Bömmel1
Author affiliations
Section of Hepatology, Clinic for Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany
Max von Pettenkofer—Institute for Hygiene and Clinical Microbiology, Ludwig-Maximilians-Universität, Munich, Germany
National Reference Center for Hepatitis B and D Viruses, Institute for Medical Virology, German Centre for Infection Research (DZIF), Justus Liebig University Giessen, Giessen, Germany
Correspondence to Dr Florian van Bömmel, Section of Hepatology, Clinic for Gastroenterology and Rheumatology, University Hospital Leipzig AöR, Liebigstraße 20, 04103 Leipzig, Germany; [email protected]
Abstract
Objective Among individuals with chronic hepatitis B, those with hepatitis B e-antigen (HBeAg)-negative chronic hepatitis (CHB) can be difficult to distinguish from those with HBeAg-negative chronic HBV infection, also referred to as inactive HBV carriers (ICs), but both require different medical management. The level of HBV surface antigen (HBsAg) has been proposed as a marker to discriminate between chronic infection and hepatitis stages. HBsAg consists of large, middle and small HBs. The aim of this study was to determine whether the composition of HBsAg improved the identification of ICs among HBsAg-positive subjects with different phases of HBV infections.
Design HBV large surface proteins (LHBs) and HBV middle surface proteins (MHBs) were quantified in serum samples from 183 clinically well-characterised untreated patients with acute (n=14) HBV infection, ICs (n=44), CHBs (n=46), chronic HBeAg-positive phase (n=68) and hepatitis delta coinfection (n=11) using an ELISA, with well-defined monoclonal antibodies against the preS1 domain (LHBs) and the preS2-domain (MHBs). A Western blot analysis was used to verify the quantitation of the components of HBsAg. Total HBsAg was quantified using a modified commercially available assay (HBsAg V.6.0, Enzygnost, Siemens, Erlangen).
Results The composition of HBsAg showed specific patterns across different phases of hepatitis B. Individuals in the IC phase had significantly lower proportions of LHBs and MHBs than patients in acute or chronic phases irrespective of their HBV e-antigen status (p<0.0001) or HBsAg level. Both LHBs and MHBs ratios better predicted the IC phase than total HBsAg levels.
Conclusion Quantification of MHBs, particularly LHBs represents a novel tool for the identification of the IC stage.
Maria Pfefferkorn1,StephanBöhm2,Tina Schott1,Danilo Deichsel1,Corinna M Bremer3,KathrinSchröder3,Wolfram H Gerlich3,Dieter Glebe3,Thomas Berg1,FlorianvanBömmel1
作者隶属关系
德国莱比锡莱比锡大学医院消化内科和风湿病学肝脏病科
Max von Pettenkofer-德国慕尼黑Ludwig-Maximilians-Universität卫生与临床微生物研究所
国家乙型和乙型病毒参考中心,医学病毒学研究所,德国感染研究中心(DZIF),Justus Liebig University Giessen,Giessen,德国