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Core antigen expression is associated with hepatic necroinflammation in e antigen-negative chronic hepatitis B

Yi-Hsiang Huang1, Hung-Hsu Hung, Che-Chang Chan

  • 1Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei 112, Taiwan. yhhuang@vghtpe.gov.tw

Clinical and Vaccine Immunology : CVI
|April 30, 2010
PubMed

Insights

Intrahepatic hepatitis B virus core antigen (HBcAg) expression is uncommon in HBeAg-negative chronic hepatitis B. However, HBcAg presence signifies active liver inflammation, even with low viral loads, highlighting its role in disease progression.

Area of Science:

  • Hepatology
  • Virology
  • Immunohistochemistry

Background:

  • Intrahepatic hepatitis B virus core antigen (HBcAg) expression is a known indicator of viral replication in HBeAg-positive chronic hepatitis B (CHB).
  • The significance of HBcAg in HBeAg-negative CHB, a distinct clinical entity, requires further elucidation.
  • Understanding HBcAg's role is crucial for assessing disease activity and guiding treatment in CHB patients.

Purpose of the Study:

  • To evaluate the prevalence and clinical significance of intrahepatic HBcAg expression in HBeAg-negative CHB patients.
  • To identify factors associated with HBcAg expression in this patient cohort.
  • To determine the relationship between HBcAg expression and hepatic necroinflammation, particularly in relation to HBV DNA load.

Main Methods:

  • Retrospective analysis of 106 HBeAg-negative CHB patients who underwent liver biopsy.
  • Assessment of intrahepatic HBcAg expression using immunohistochemistry.
  • Correlation of HBcAg status with HBV DNA levels, serum alanine transaminase (ALT), and histological findings (necroinflammation).

Main Results:

  • HBcAg was detected in 33% of HBeAg-negative CHB patients.
  • HBcAg positivity was associated with higher HBV DNA levels (>10^7 copies/ml) and elevated ALT levels (>160 U/liter).
  • In patients with lower HBV DNA loads, HBcAg expression was a significant predictor of active hepatic necroinflammation (HR=11.25, P=0.022).

Conclusions:

  • Intrahepatic HBcAg expression is not frequent but is a significant marker of active hepatic necroinflammation in HBeAg-negative CHB.
  • HBcAg presence indicates disease activity even in patients with low HBV DNA levels.
  • Both HBV viral load and HBcAg expression are important factors in the pathogenesis of HBeAg-negative CHB.

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