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Serum HBV-DNA in delta antigen positive chronic liver disease
Insights
Hepatitis B virus (HBV) DNA replication is significantly lower in patients with chronic liver disease (CLD) who are positive for Hepatitis D virus antigen (delta Ag). This suggests distinct HBV replication patterns based on delta Ag status.
Area of Science:
- Hepatology
- Virology
- Molecular Biology
Background:
- Chronic liver disease (CLD) affects millions globally.
- Hepatitis B virus (HBV) infection is a major cause of CLD.
- Hepatitis D virus (HDV) coinfection can alter HBV pathogenesis.
Purpose of the Study:
- To compare HBV DNA replication levels in patients with HBsAg+/delta Ag+ CLD versus HBsAg+/delta Ag- CLD.
- To investigate the correlation between HBV DNA levels and liver-specific viral antigen detection.
Main Methods:
- Serum HBV DNA was quantified using molecular hybridization.
- Hepatitis B core antigen (HBcAg) and delta Ag were detected in liver tissue via direct immunofluorescence.
- Patient cohorts were matched for histological diagnosis and HBeAg/anti-HBe status.
Main Results:
- 81% of delta Ag+ patients had undetectable or trace serum HBV DNA, compared to 43% in delta Ag- patients.
- Delta Ag- patients showed significantly higher serum HBV DNA levels (2+ to 4+).
- Liver HBcAg detection correlated with strong serum HBV DNA levels.
Conclusions:
- HBV replication is significantly suppressed in the presence of delta Ag in HBsAg+ CLD patients.
- Molecular hybridization is crucial for understanding HBV and HDV pathogenetic and epidemiological dynamics.
- Distinct HBV replication profiles exist between delta Ag-positive and negative CLD patients.
Abstract:
HBV DNA was assayed by molecular hybridization in the serum of 21 patients with HBsAg + /delta Ag + chronic liver disease (CLD). The results were compared to those in 21 HBsAg + /delta Ag - cases matched for histological diagnosis and HBeAg/anti-HBe status and to HBcAg and delta Ag detection in the liver by direct immunofluorescence. In the delta Ag + cases serum HBV DNA was either negative (17/21 or 81%) or transiently positive (4/21 or 19%) in small or trace amounts (trace to 1 +). By contrast 9 of 21 (43%) of HBsAg + delta Ag - cases were serum HBV DNA positive, 6 of them having values ranging from 2 + to 4 +. HBcAg was detected in the liver of patients with strong serum HBV DNA reactions and was absent from all serum HBV DNA negative ones. These results indicate a significant difference in the HBV replication level between delta Ag positive and negative patients with HBsAg + CLD and with comparable liver histology and HBeAg/anti-HBe status, and support the need for wider application of molecular hybridization techniques in the pathogenetic and epidemiological study of HBV infection.