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Published on: February 19, 2019
Hepatitis B core and surface antigen expression in HBeAg and HBV DNA positive chronic hepatitis B: correlation with
1Department of Medicine, University of the Witwatersrand Medical School, Johannesburg, South Africa.
Insights
Hepatitis B virus (HBV) antigen expression and liver injury show a complex relationship in chronic HBV infection. This study found that hepatitis B core antigen (HBcAg) expression and liver damage are often dissociated, suggesting intricate host responses influence disease activity.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- The interplay between hepatitis B virus (HBV) infection, liver damage, and disease activity in chronic HBV is not fully understood.
- Assessing HBV replication, antigen expression, and histologic activity is crucial for understanding disease pathogenesis.
Purpose of the Study:
- To correlate hepatitis B surface antigen (HBsAg) and hepatitis B core antigen (HBcAg) expression with histologic liver disease in chronic HBV infection.
- To investigate the relationship between HBV antigen expression, liver injury, and clinical activity.
Main Methods:
- Studied 47 liver biopsies from HBeAg-positive chronic HBV patients using immunochemical staining for HBsAg and HBcAg.
- Scored histologic activity and assessed HBV replication.
- Correlated antigen expression with histologic activity, HBV replication, and serum aminotransferase levels.
Main Results:
- No correlation was found between HBsAg expression and histologic activity.
- Intracytoplasmic HBcAg was observed in patients with minimal hepatitis and those seroconverting to anti-HBe.
- An inverse correlation between histologic score and HBcAg expression was noted, with higher HBcAg in chronic persistent hepatitis (CPH) than chronic active hepatitis (CAH).
- Serum aminotransferase concentrations positively correlated with histologic score.
Conclusions:
- HBcAg expression and liver injury are frequently dissociated in chronic HBV infection.
- Complex host immune responses likely dictate the variable degree of disease activity and hepatic injury.
- Further research is needed to elucidate the intricate mechanisms governing HBV pathogenesis and disease progression.
Abstract:
The interrelationship between hepatitis B virus (HBV) infection, hepatic injury and clinical activity in chronic HBV infection is incompletely understood. We have scored histologic activity, the expression of hepatitis B core (HBcAg) and hepatitis B surface antigen (HBsAg) and assessed HBV replication to correlate HBV antigen expression with histologic disease. Forty-seven formalin-fixed, percutaneous liver biopsies from HBeAg carriers were studied. Twenty-nine were Black, 16 Caucasian and two Oriental. Fifty-nine percent had chronic active, 35% chronic persistent hepatitis and 14% cirrhosis. None were positive for antibodies to Human Immunodeficiency Virus (HIV). HBsAg and HBcAg in tissue were detected by immunochemical staining. Diffuse HBsAg staining was observed in 10/15 patients with CPH, but there was no correlation between histologic score and HBsAg expression. Intracytoplasmic HBcAg was observed in patients seroconverting to anti-HBe, but was also detected in patients with minimal hepatitis. An inverse correlation between histologic score and HBcAg expression was observed. HBcAg expression was more widespread in patients with CPH (mean 37%) than in CAH (mean 18%). A positive correlation was observed between serum aminotransferase concentrations and histologic score. Although no consistent pattern can be discerned, HBcAg expression and hepatic injury are frequently dissociated in patients with chronic HBV infection; complex host responses may determine the variable degree of disease activity and hepatic injury.
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