Expression of hepatocyte hepatitis B core antigen and hepatitis B surface antigen as a marker in the management of chronic hepatitis B patients

Sun Young Yim, Tae Hyung Kim, Suh Sang Jun, Eun-Sun Kim, Bora Keum, Yeon Seok Seo, Hyung Joon Yim, Yoon Tae Jeen, Hoon-Jai Chun, Hong Sik Lee, Soon-Ho Um, Chang Duck Kim, Nam Hee Won, Ho Sang Ryu

Research output: Contribution to journalArticle

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Abstract

Background/Aims: 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). Methods: 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. Results: 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). Conclusions: Hepatocyte HBcAg/HBsAg expression is a good marker for disease status and predicting treatment response.

Original languageEnglish
Pages (from-to)417-425
Number of pages9
JournalGut and Liver
Volume11
Issue number3
DOIs
Publication statusPublished - 2017 May 1

Fingerprint

Hepatitis B Core Antigens
Chronic Hepatitis B
Hepatitis B Surface Antigens
Hepatocytes
Hepatitis B e Antigens
Fibrosis
Viremia
Viral Load
Serum
Cytoplasm
Therapeutics
Biopsy

Keywords

  • Hepatitis B core antigens
  • Hepatitis B surface antigens
  • Hepatitis B, chronic
  • Histologic activity index

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Expression of hepatocyte hepatitis B core antigen and hepatitis B surface antigen as a marker in the management of chronic hepatitis B patients. / 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.

In: Gut and Liver, Vol. 11, No. 3, 01.05.2017, p. 417-425.

Research output: Contribution to journalArticle

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abstract = "Background/Aims: 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). Methods: 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. Results: 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). Conclusions: Hepatocyte HBcAg/HBsAg expression is a good marker for disease status and predicting treatment response.",
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T1 - Expression of hepatocyte hepatitis B core antigen and hepatitis B surface antigen as a marker in the management of chronic hepatitis B patients

AU - Yim, Sun Young

AU - Kim, Tae Hyung

AU - Jun, Suh Sang

AU - Kim, Eun-Sun

AU - Keum, Bora

AU - Seo, Yeon Seok

AU - Yim, Hyung Joon

AU - Jeen, Yoon Tae

AU - Chun, Hoon-Jai

AU - Lee, Hong Sik

AU - Um, Soon-Ho

AU - Kim, Chang Duck

AU - Won, Nam Hee

AU - Ryu, Ho Sang

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AB - Background/Aims: 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). Methods: 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. Results: 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). Conclusions: Hepatocyte HBcAg/HBsAg expression is a good marker for disease status and predicting treatment response.

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KW - Hepatitis B surface antigens

KW - Hepatitis B, chronic

KW - Histologic activity index

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