Expression of Hepatocyte Hepatitis B Core Antigen and Hepatitis B Surface Antigen as a Marker in the Management of Chronic Hepatitis B Patients

• Published in: Gut and liver Vol. 11; no. 3; pp. 417 - 425
• Main Authors: Yim, Sun Young, Kim, Tae Hyung, Jun, Suh Sang, Kim, Eun Sun, Keum, Bora, Seo, Yeon Seok, Yim, Hyung Joon, Jeen, Yoon Tae, Chun, Hoon Jai, Lee, Hong Sik, Um, Soon Ho, Kim, Chang Duck, Won, Nam Hee, Ryu, Ho Sang
• Format: Journal Article
• Language: English
• Published: Korea (South) Editorial Office of Gut and Liver 01.05.2017; Gastroenterology Council for Gut and Liver; 거트앤리버 소화기연관학회협의회
• Subjects: Adult; Antiviral Agents - therapeutic use; Biomarkers - analysis; Biopsy; chronic; Female; Guanine - analogs & derivatives; Guanine - therapeutic use; hepatitis b; hepatitis b core antigens; Hepatitis B Core Antigens - immunology; Hepatitis B Core Antigens - metabolism; Hepatitis B e Antigens - immunology; Hepatitis B e Antigens - metabolism; hepatitis b surface antigens; Hepatitis B Surface Antigens - immunology; Hepatitis B Surface Antigens - metabolism; Hepatitis B virus - immunology; Hepatitis B, Chronic - drug therapy; Hepatitis B, Chronic - immunology; Hepatitis B, Chronic - virology; Hepatocytes - immunology; Hepatocytes - virology; histologic activity index; Humans; Liver - immunology; Liver - pathology; Liver - virology; Male; Middle Aged; Original; Retrospective Studies; Treatment Outcome; 내과학; Hepatitis B core antigens; Hepatitis B surface antigens; Histologic activity index; chronic; Hepatitis B
• ISSN: 1976-2283; 2005-1212
• DOI: 10.5009/gnl16148

We aimed to clarify the association of hepatitis B surface antigen (HBsAg)/hepatitis B core antigen (HBcAg) with the disease status and treatment response in patients with chronic hepatitis B (CHB). We investigated 171 biopsy-proven entecavir-treated CHB patients (109 hepatitis B e antigen [HBeAg]-positive, 62 HBeAg-negative). HBcAg expression was positive when ≥10% of hepatocytes stained, and classified into nuclear, mixed, and cytoplasmic patterns. HBsAg expressions were intracytoplasmic (diffuse, globular, and submembranous) and membranous. The histologic activity index (HAI) and fibrosis stage followed Ishak system. In HBeAg-positive patients, older age, increased HAI score, advanced fibrosis, and reduced viral load were observed when HBcAg expression shifted from nucleus to cytoplasm in HBcAg-positive patients, and HBsAg expression from non-submembranous to submembranous in HBcAg-negative patients (all, p<0.05). In HBeAg-negative patients, only intracytoplasmic HBsAg expression patterns had clinical relevance with decreased ALT levels and viremia. In HBeAg-positive patients without favorable predictors of virologic response, negative HBcAg and membranous HBsAg expression predicted greater virologic response (both, p<0.05). The probability of HBeAg seroclearance was higher in patients with increased HAI or lacking HBcAg expression (both, p<0.05). Higher serum HBsAg levels and hepatocyte HBcAg positivity were associated with reduced serum HBsAg during first and post-first year treatment, respectively (both, p<0.05). Hepatocyte HBcAg/HBsAg expression is a good marker for disease status and predicting treatment response.