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Published on: February 19, 2019
HBsAg expression of liver correlates with histological activities and viral replication in chronic hepatitis B
Pin-Nan Cheng1, Yen-Cheng Chiu1, Hung-Wen Tsai2
1Department Internal Medicine, Institute of Medicine, Medical College of National Cheng Kung University. Taiwan.
Insights
Intrahepatic hepatitis B surface antigen (HBsAg) expression patterns and levels correlate with chronic hepatitis B severity. Basal core promoter mutations are linked to specific HBsAg expression patterns and disease progression.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Intrahepatic hepatitis B surface antigens (HBsAg) expression is a key factor in chronic hepatitis B disease progression.
- Understanding the features of intrahepatic HBsAg expression is crucial for managing the disease.
Purpose of the Study:
- To examine the features of intrahepatic HBsAg expression.
- To evaluate the association between intrahepatic HBsAg expression and clinical, viral, and histological characteristics in patients with chronic hepatitis B.
Main Methods:
- 181 patients with e antigen positive chronic hepatitis B were enrolled.
- Analysis of intrahepatic HBsAg expression patterns and semi-quantitative measurement.
- Evaluation of associations with clinical, viral, and histological data.
Main Results:
- Patients with type II ground glass hepatocytes and higher intrahepatic HBsAg expression (2+/3+) showed increased necroinflammation and fibrosis but lower serum HBV DNA and HBsAg levels.
- Basal core promoter T1762/A1764 mutations were significantly associated with type II ground glass hepatocyte pattern and higher intrahepatic HBsAg expression.
- Multivariate analysis confirmed basal core promoter mutations as an independent factor associated with 2+/3+ scale HBsAg expression.
Conclusions:
- Both the pattern and level of intrahepatic HBsAg expression are linked to the severity of liver disease in e antigen positive chronic hepatitis B.
- The strong correlation between intrahepatic HBsAg expression and basal core promoter mutations suggests HBsAg expression reflects viral genomic evolution under immune pressure.
Introduction:
The intrahepatic hepatitis B surface antigens (HBsAg) expression is related to disease progression of chronic hepatitis B. We examined the features of intrahepatic HBsAg expression.
Material And Methods:
A total of 181 patients with e antigen positive chronic hepatitis B were enrolled. Patterns and semi-quantitative measurement of intrahepatic HBsAg expression were analyzed. The association of intrahepatic hepatitis HBsAg expression with clinical, viral, and histological characteristics was evaluated.
Results:
Higher necroinflammation grade and greater fibrosis stage accompanied with lower serum HBV DNA and HBsAg levels were observed in patients with type II ground glass hepatocytes and 2+/3+ scales of intrahepatic HBsAg expression. Basal core promoter T1762/A1764 mutations were strongly associated with the pattern of type II ground glass hepatocytes expression (P < 0.001) and higher level of HBsAg expression (9.3 ± 8.0% vs. 4.3 ± 5.0%, P = 0.008). In multivariate analysis, basal core promoter mutations (Odds ratio: 6.356, 95% confidence interval: 1.204 ~ 33.356, P = 0.029) was associated with 2+/3+ scale of HBsAg expression.
Conclusion:
Both pattern and levels of intrahepatic HBsAg expression were associated with severity of liver disease in e antigen positive chronic hepatitis B. Strong relationship between intrahepatic HBsAg expression and basal core promoter 1762/A1764 mutations indicated that HBsAg expression may be the histological manifestation of hepatitis B virus genomic evolution under host immune surveillance.
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