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Published on: February 19, 2019
Hepatitis B core antigen in liver tissue from HBs-positive, HBe-negative patients
Ewa Karpinska1, Marta Wawrzynowicz-Syczewska, Maria Chosia
1Department of Infectious Diseases, Pomeranian Medical University, Szczecin, Poland. ewakapinska@interia.pl
Insights
Hepatitis B core antigen (HBcAg) detection in liver tissue is crucial for HBeAg-negative patients. Immunohistochemistry for HBcAg can help identify elevated aminotransferase levels unrelated to active Hepatitis B virus (HBV) infection.
Area of Science:
- Hepatology
- Virology
- Immunohistochemistry
Background:
- Hepatitis B e antigen (HBeAg)-negative patients represent a distinct clinical group in Hepatitis B virus (HBV) infection.
- Understanding the role of Hepatitis B core antigen (HBcAg) in liver tissue is important for managing these patients.
- Liver biopsy and HBV DNA levels are key indicators of disease activity.
Purpose of the Study:
- To investigate the correlation between HBcAg in liver tissue, liver disease activity, and serum HBV DNA levels.
- To assess the utility of HBcAg immunostaining in HBeAg-negative patients.
- To differentiate HBV-related liver damage from other causes of elevated liver enzymes.
Main Methods:
- Analysis of 49 liver biopsy specimens from HBeAg-negative patients.
- Immunohistochemical staining for HBcAg in liver tissue.
- Detection of serum HBV DNA using hybridization and PCR methods.
Main Results:
- HBcAg was detected in 32.6% of liver biopsy specimens.
- A significant association was observed between HBcAg expression and elevated ALT/AST levels.
- 15 out of 16 patients with detectable HBcAg were positive for serum HBV DNA.
Conclusions:
- Immunohistochemical detection of HBcAg is essential for classifying HBeAg-negative patients for antiviral therapy.
- HBcAg immunostaining can help exclude non-HBV causes of aminotransferase elevation.
- This method aids in accurate diagnosis and treatment decisions in chronic HBV infection.
Background/Aims:
We aimed to study the relationship between HBcAg in liver tissue, histological and biochemical activity and serum HBV-DNA levels among HBeAg-negative patients.
Methodology:
49 biopsy specimens taken from 16 females and 29 males were studied. Immunostaining for HBcAg was performed with commercially available kits (Dako). Serum HBV-DNA was detected by the hybridization method, in case of negative hybridization, repeated by PCR.
Results:
HBcAg was found in 16 biopsy specimens (32.6%) (group I)--in 10 cases in hepatocytes nuclei and cytoplasm, in 5 in the nuclei and in one case in cytoplasm only. 15 out of 16 patients were serum HBV-DNA positive. Seven patients showed chronic liver disease of moderate or severe activity with HBcAg expression both in the nuclei and cytoplasm. Group II consisted of 33 patients who were HBcAg-negative. In 7 patients HBV-DNA was not found by hybridization or by PCR. In eleven patients ALT and AST activity exceeded 1.5x the ULN. ALT and AST differed significantly between group II and I.
Conclusions:
In our opinion immunohistochemical examination is an essential part of classification to antiviral treatment. HBcAg immunostaining should be performed in every HBeAg-negative patient to exclude reasons for aminotransferase elevation other than HBV infection.
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