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Published on: February 19, 2019
Quantitative intrahepatic HBV cccDNA correlates with histological liver inflammation in chronic hepatitis B virus
Ling-Bo Liang1, Xia Zhu2, Li-Bo Yan2
1Center of Infectious Disease, State Key Laboratory of Biotherapy, West China Hospital, West China School of Medicine, Sichuan University, 37# Guoxue Lane, 610041 Chengdu, China; Division of General Practice, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China.
Insights
Higher baseline hepatitis B virus (HBV) covalently closed circular DNA (cccDNA) levels in the liver may predict future liver inflammation in patients with chronic HBV infection. This finding could aid in managing patients requiring extended outpatient care.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Chronic hepatitis B virus (HBV) infection affects millions globally.
- Liver inflammation is a key factor in HBV disease progression.
- Understanding predictors of inflammation in minimally active HBV is crucial for patient management.
Purpose of the Study:
- To investigate the role of baseline intrahepatic HBV covalently closed circular DNA (cccDNA) in predicting liver inflammation.
- To assess HBV cccDNA as a marker in patients with low serum alanine aminotransferase (ALT) levels.
Main Methods:
- Prospective study of 102 patients with chronic HBV infection.
- Inclusion criteria: serum ALT < 2×ULN and histological inflammation < G2.
- Monitoring of virological, biochemical, and inflammation markers over a median of 4.1 years.
Main Results:
- 68 patients met inclusion criteria; 41 (60.3%) developed inflammation during follow-up.
- Higher baseline intrahepatic HBV cccDNA (>1 copy/cell) was an independent predictor of inflammation (OR 9.43, p=0.049).
- Baseline liver inflammation grade ≥G1 also predicted future inflammation (OR 5.77, p=0.046).
Conclusions:
- Elevated baseline intrahepatic HBV cccDNA levels are associated with an increased risk of liver inflammation.
- HBV cccDNA may serve as an intrahepatic virological marker for identifying patients needing extended outpatient management.
- Further research is needed to validate HBV cccDNA's role in clinical decision-making.
Background:
The aim of this study was to determine the role of baseline hepatitis B virus (HBV) forming covalently closed circular DNA (HBV cccDNA) in liver inflammation in patients infected with HBV with serum alanine aminotransferase (ALT) levels under two times the upper limit of normal (2×ULN).
Methods:
After liver biopsy and serum virological and biochemical marker screening, patients diagnosed with chronic HBV infection with serum ALT levels under 2×ULN and histological liver inflammation of less than grade G2 were prospectively recruited into this study. Recruitment took place between March 2009 and November 2010 at the Center of Infectious Disease, Sichuan University. Patient virological and biochemical markers, as well as markers of liver inflammation, were monitored.
Results:
A total of 102 patients were recruited and 68 met the inclusion criteria; the median follow-up was 4.1 years (range 3.9-5.2 years). During follow-up, 41 patients (60.3%) exhibited signs of inflammation. Baseline HBV cccDNA >1 copy/cell (odds ratio 9.43, p=0.049) and liver inflammation grade ≥G1 (odds ratio 5.77, p=0.046) were both independent predictors of liver inflammation.
Conclusions:
A higher baseline intrahepatic HBV cccDNA level may increase the risk of liver inflammation. Further investigations will be required to validate HBV cccDNA as an intrahepatic virological marker of patients who require extended outpatient management.
