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2100
Hepatitis B Core Related Antigen Is Correlated
with Several Hepatitis B Virus Markers Including
Serum HBV RNA and Intrahepatic Cccdna.
Robin Erken, Gastroenterology, Academic Medical Centre
Amsterdam, Hans L Zaaijer, Virology, Academic Medical
Centra Amsterdam, Ed Bakker, Sanquin, Neeltje Kootstra,
Experimental Immunology, Academic Medical Centre
Amsterdam and Hendrik W. Reesink, University of Amsterdam
Background: Hepatitis B viral closed circular DNA (cccDNA)
is located in the nucleus of the hepatocyte and can only be
extracted and determined from liver biopsy material. Since
various HBV direct acting antiviral compounds are under
development for functional and total cure, it is important to
establish validated tests that reflect the intrahepatic viral
replicative activity the liver of chronic hepatitis B (CHB)
patients. Hepatitis B core-related antigen (HBcrAg) has
recently been reported as a new serum marker that reflects
intrahepatic cccDNA. Other markers of HBV replication are
HBV-DNA, HBsAg and HBV-RNA. For HBV-RNA commercial
test are currently unavailable. Aim: To investigate the
correlation between HBcrAg and cccDNA and HBV-DNA from
liver tissue and HBV-DNA, HBV-RNA and HBsAg of serum
or plasma from CHB patients. Methods: Baseline serum
or plasma samples as well as liver tissue were available
of 88 CHB patients that were treated with Peg interferon
and Adefovir in a prospective clinical study as described
previously. HBcrAg levels were measured in serum or plasma
at baseline with a lower limit of detection of 3 log10U/mL.
These HBcrAg levels were compared to intrahepatic cccDNA
and HBV DNA levels as well as serum levels of HBsAg, HBV
DNA, and HBV RNA from corresponding samples. Also the
HBeAg status of the patients was established. Comparisons
were made using the Mann-Whitney U test and Spearman
correlation test, correlation coefficient (CC) values were
given. Results: HBcrAg serum levels were median 5.9 log10
U/mL (IQR 4.5-8.0). Of all patients HBcrAg level correlated
well with the serum markers: HBsAg (CC 0.57, p<0.001), HBV
DNA (CC 0.82, p<0.001), HBV RNA (cc 0.84, p<0.001) as well
as with intrahepatic cccDNA (cc 0.78, p<0.001) and HBV DNA
(cc 0.75, p<0.001). HBcrAg levels of HBeAg positive patients
(median 8.0, IQR 6.6-8.4 log10U/mL) were significantly higher
(p> 0.001) than those of HBeAg negative patients (median
4.7, IQR 4.1-5.6 log10U/mL). When analyzing the patients
according to HBeAg status, similar results were obtained
for serum HBV DNA and RNA and intrahepatic cccDNA and
HBV-DNA. However HBsAg was correlated with HBcrAg
only in HBeAg positive patients and not in HBeAg negative
patients (table). Conclusion: HBcrAg levels were strongly
correlated with intrahepatic levels of cccDNA and HBV-DNA
and with serum/plasma HBV DNA and RNA. HBsAg was only
correlated with HBcrAg in HBeAg positive but not in negative
patients.
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