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Lazarevic I, Miljanovic D, Banko A, Cupic M, Cirkovic A. Quantitative HBV Core Antibodies as a Prognostic Marker for HBeAg Seroclearance: A Systematic Review with Meta-Analysis. Viruses 2024; 16:1121. [PMID: 39066283 PMCID: PMC11281513 DOI: 10.3390/v16071121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 07/07/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
During chronic hepatitis B virus (HBV) infection, the seroclearance of hepatitis B e antigen (HBeAg) is an important event and a significant surrogate endpoint of all current therapeutic strategies. The prediction of HBeAg seroclearance can help assess the benefits of therapy in patients during or before therapy initiation. The quantitation of HBV core antibodies (qAnti-HBc) is a new non-invasive biomarker for solving multiple diagnostic dilemmas. A systematic review and meta-analysis of studies that measured qAnti-HBc in patients who achieved HBeAg seroclearance were performed through PubMed, Web of Science (WoS) and SCOPUS electronic database searches. Nineteen articles were included in the systematic review, comprising 3434 chronically infected patients (1014 with and 2420 without HBeAg seroclearance). Sixteen publications with data regarding qAnti-HBc levels were included in the meta-analysis. The baseline level of qAnti-HBc antibodies was significantly higher in patients with than without HBeAg seroclearance (SMD = 0.88, 95%CI SMD = 0.56-1.2, p < 0.001). The same conclusion was reached for patients originating from Asia (SMD = 0.94, 95%CI SMD = 0.55-1.33) and for the qAnti-HBc antibodies among adult HBV patients with therapy-induced HBeAg seroclearance (SMD = 0.90, 95%CI SMD = 0.54-1.25, p < 0.001). The systematic review and meta-analysis provide evidence of the role of qAnti-HBc as a promising biomarker for predicting HBeAg seroclearance in chronically infected patients.
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Affiliation(s)
- Ivana Lazarevic
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.M.); (A.B.); (M.C.)
| | - Danijela Miljanovic
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.M.); (A.B.); (M.C.)
| | - Ana Banko
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.M.); (A.B.); (M.C.)
| | - Maja Cupic
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.M.); (A.B.); (M.C.)
| | - Andja Cirkovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
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Zhang PX, Zheng XW, Zhang YF, Ye J, Li W, Tang QQ, Zhu J, Zou GZ, Zhang ZH. Prediction model for hepatitis B e antigen seroconversion in chronic hepatitis B with peginterferon-alfa treated based on a response-guided therapy strategy. World J Hepatol 2024; 16:405-417. [PMID: 38577530 PMCID: PMC10989310 DOI: 10.4254/wjh.v16.i3.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/27/2023] [Accepted: 02/01/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Models for predicting hepatitis B e antigen (HBeAg) seroconversion in patients with HBeAg-positive chronic hepatitis B (CHB) after nucleos(t)ide analog treatment are rare. AIM To establish a simple scoring model based on a response-guided therapy (RGT) strategy for predicting HBeAg seroconversion and hepatitis B surface antigen (HBsAg) clearance. METHODS In this study, 75 previously treated patients with HBeAg-positive CHB underwent a 52-week peginterferon-alfa (PEG-IFNα) treatment and a 24-wk follow-up. Logistic regression analysis was used to assess parameters at baseline, week 12, and week 24 to predict HBeAg seroconversion at 24 wk post-treatment. The two best predictors at each time point were used to establish a prediction model for PEG-IFNα therapy efficacy. Parameters at each time point that met the corresponding optimal cutoff thresholds were scored as 1 or 0. RESULTS The two most meaningful predictors were HBsAg ≤ 1000 IU/mL and HBeAg ≤ 3 S/CO at baseline, HBsAg ≤ 600 IU/mL and HBeAg ≤ 3 S/CO at week 12, and HBsAg ≤ 300 IU/mL and HBeAg ≤ 2 S/CO at week 24. With a total score of 0 vs 2 at baseline, week 12, and week 24, the response rates were 23.8%, 15.2%, and 11.1% vs 81.8%, 80.0%, and 82.4%, respectively, and the HBsAg clearance rates were 2.4%, 3.0%, and 0.0%, vs 54.5%, 40.0%, and 41.2%, respectively. CONCLUSION We successfully established a predictive model and diagnosis-treatment process using the RGT strategy to predict HBeAg and HBsAg seroconversion in patients with HBeAg-positive CHB undergoing PEG-IFNα therapy.
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Affiliation(s)
- Pei-Xin Zhang
- Department of Infectious Diseases, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Xiao-Wei Zheng
- Department of Infectious Diseases, Anhui Provincial Hospital, Hefei 230000, Anhui Province, China
| | - Ya-Fei Zhang
- Department of Infectious Diseases, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Jun Ye
- Department of Infectious Diseases, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Wei Li
- Department of Hepatology, The Second People's Hospital of Fuyang City, Fuyang 236000, Anhui Province, China
| | - Qian-Qian Tang
- Department of Infectious Diseases, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Jie Zhu
- Department of Infectious Diseases, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Gui-Zhou Zou
- Department of Infectious Diseases, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Zhen-Hua Zhang
- Department of Infectious Diseases, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China.
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王 馨, 唐 小, 韩 宁, 唐 红. [Research progress of biomarkers of hepatitis B virus and clinical significance]. SHENG WU YI XUE GONG CHENG XUE ZA ZHI = JOURNAL OF BIOMEDICAL ENGINEERING = SHENGWU YIXUE GONGCHENGXUE ZAZHI 2023; 40:1242-1248. [PMID: 38151949 PMCID: PMC10753316 DOI: 10.7507/1001-5515.202309041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/10/2023] [Indexed: 12/29/2023]
Abstract
The infection of Hepatitis B virus (HBV) can result in severe consequences, including chronic hepatitis, liver fibrosis, cirrhosis, and even liver cancer. Effective antiviral treatment has the potential to slow down the progression of the disease. HBV serum biomarkers play a crucial role in the dynamic management of chronic hepatitis B (CHB) patients. However, the conventional hepatitis B virus markers, such as hepatitis B serologic testing and HBV DNA, are insufficient to meet the clinical requirements. This review provided a comprehensive overview of the current research on the quantification of HBsAg and anti-HBc, HBV RNA and HBV core-associated antigen, which summarized the crucial role these markers play in the administration of antiviral medications, predicting the efficacy of treatment and anticipating the likelihood of virologic rebound following drug cessation, as well as assessing disease progression in CHB patients.
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Affiliation(s)
- 馨 王
- 四川大学华西医院 感染性疾病中心(成都 610041)Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, P. R. China
- 四川大学华西医院 生物治疗国家重点实验室 感染性疾病研究室(成都 610041)Divison of Infectious Diseases, State Key Laboratory of Biotherapy and Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, P. R. China
| | - 小琼 唐
- 四川大学华西医院 感染性疾病中心(成都 610041)Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, P. R. China
- 四川大学华西医院 生物治疗国家重点实验室 感染性疾病研究室(成都 610041)Divison of Infectious Diseases, State Key Laboratory of Biotherapy and Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, P. R. China
| | - 宁 韩
- 四川大学华西医院 感染性疾病中心(成都 610041)Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, P. R. China
- 四川大学华西医院 生物治疗国家重点实验室 感染性疾病研究室(成都 610041)Divison of Infectious Diseases, State Key Laboratory of Biotherapy and Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, P. R. China
| | - 红 唐
- 四川大学华西医院 感染性疾病中心(成都 610041)Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, P. R. China
- 四川大学华西医院 生物治疗国家重点实验室 感染性疾病研究室(成都 610041)Divison of Infectious Diseases, State Key Laboratory of Biotherapy and Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, P. R. China
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Elizalde MM, Giadans CG, Campos RH, Flichman DM. Impact of core protein naturally selected mutants associated with HBeAg-negative status in HBV biosynthesis. J Med Virol 2023; 95:e29195. [PMID: 37881005 DOI: 10.1002/jmv.29195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/04/2023] [Accepted: 10/11/2023] [Indexed: 10/27/2023]
Abstract
Hepatitis B e antigen (HBeAg) loss represents a late stage of chronic hepatitis B virus (HBV) infection associated with a drastic decrease in HBV-DNA, a lower risk of disease progression, and the occurrence of several mutations in the preCore/core region. However, the underlying mechanisms supporting the downregulation of viral replication have yet to be elucidated. In the present study, the analysis of the frequency of subgenotype D1 core protein (HBc) mutations associated with HBeAg status revealed a higher mutation rate in HBeAg-negative sequences compared to HBeAg-positive ones. Particularly, 22 amino acids exhibited a higher frequency of mutation in HBeAg-negative sequences, while the remaining residues showed a high degree of conservation. Subsequently, the assessment of HBc mutants derived from HBeAg-negative patients in viral structure and replicative capacity revealed that HBc mutations have the ability to modulate the subcellular localization of the protein (either when the protein was expressed alone or in the context of viral replication), capsid assembly, and, depending on specific mutation patterns, alter covalently closed circular DNA (cccDNA) recycling and up- or downregulate viral replication. In conclusion, HBc mutations associated with HBeAg-negative status impact on various stages of the HBV life cycle modulating viral replication during the HBeAg-negative stage of infection.
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Affiliation(s)
- María Mercedes Elizalde
- Facultad de Medicina, Departamento de Microbiología, Parasitología e Inmunología, Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), CONICET, Universidad de Buenos Aires, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Cecilia Graciela Giadans
- Facultad de Medicina, Departamento de Microbiología, Parasitología e Inmunología, Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), CONICET, Universidad de Buenos Aires, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Rodolfo Héctor Campos
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
- Departamento de Microbiología, Inmunología, Biotecnología y Genética, Cátedra de Virología, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Diego Martín Flichman
- Facultad de Medicina, Departamento de Microbiología, Parasitología e Inmunología, Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), CONICET, Universidad de Buenos Aires, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
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Zhang Y, Gu Y, Yin S, Wang J, Zhang Z, Liu Y, Chen Y, Zhan J, Xue R, Yan X, Zhang S, Ding W, Chen Y, Li J, Huang R, Wu C. Baseline albumin-bilirubin score: a predictor for HBeAg clearance in patients with chronic hepatitis B after nucleos(t)ide analogue treatment. Eur J Gastroenterol Hepatol 2023; 35:1023-1029. [PMID: 37395182 DOI: 10.1097/meg.0000000000002598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
BACKGROUND Serum biomarkers for predicting HBeAg clearance in patients with chronic hepatitis B (CHB) virus infection during antiviral therapy remain lacking. This study aimed to investigate baseline albumin-bilirubin (ALBI) score for assessing HBeAg clearance in HBeAg-positive CHB patients treated with nucleos(t)ide analogues (NAs). METHODS Six hundred and ninety-nine HBeAg-positive CHB patients treated with first-line NAs were retrospectively included. Kaplan-Meier curves were used to compare the possibility of HBeAg clearance and HBeAg seroconversion in different ALBI groups. Cox regression models were used to identify factors associated with HBeAg clearance and HBeAg seroconversion. RESULTS Of the patients, 69.8% were male, with a median age of 36.0 years. 174 (24.9%) patients achieved HBeAg clearance after a median of 92.0 (interquartile range 48.0-134.0) weeks of antiviral treatment and 108 (15.5%) patients achieved HBeAg seroconversion. 74.0% and 26.0% of patients were classified as ALBI grade 1 and ALBI grade 2-3, respectively. ALBI grade 2-3 was identified as an independent predictor of HBeAg clearance (hazard ratio 1.570, 95% confidence interval 1.071-2.301, P = 0.021). The cumulative incidence of HBeAg clearance and HBeAg seroconversion was significantly higher in ALBI grade 2-3 group than group of ALBI grade 1 ( P < 0.001). Similar results were observed in different subgroups with different antiviral drugs, cirrhosis status, and ALT levels. CONCLUSION Baseline ALBI score may be a valuable indicator for predicting antiviral response in HBeAg-positive CHB patients treated with NAs.
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Affiliation(s)
- Yao Zhang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine
| | - Yan Gu
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine
| | - Shengxia Yin
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University
- Institute of Viruses and Infectious Diseases, Nanjing University
| | - Jian Wang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University
- Institute of Viruses and Infectious Diseases, Nanjing University
| | - Zhiyi Zhang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine
| | - Yilin Liu
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine
| | - Yun Chen
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing
| | - Jie Zhan
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing
| | - Ruifei Xue
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing
| | - Xiaomin Yan
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University
| | - Shaoqiu Zhang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing
| | - Weimao Ding
- Department of Hepatology, Huai'an No. 4 People's Hospital, Huai'an
| | - Yuxin Chen
- Institute of Viruses and Infectious Diseases, Nanjing University
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Jie Li
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University
- Institute of Viruses and Infectious Diseases, Nanjing University
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing
| | - Rui Huang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University
- Institute of Viruses and Infectious Diseases, Nanjing University
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing
| | - Chao Wu
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University
- Institute of Viruses and Infectious Diseases, Nanjing University
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing
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Shi Y, Wang Z, Ge S, Xia N, Yuan Q. Hepatitis B Core Antibody Level: A Surrogate Marker for Host Antiviral Immunity in Chronic Hepatitis B Virus Infections. Viruses 2023; 15:1111. [PMID: 37243197 PMCID: PMC10221631 DOI: 10.3390/v15051111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 04/28/2023] [Accepted: 04/30/2023] [Indexed: 05/28/2023] Open
Abstract
The hepatitis B virus core protein (HBcAg) is a highly immunogenic particulate antigen. Nearly all patients with persistent or resolved hepatitis B virus (HBV) infection show seropositivity for hepatitis B core antibody (anti-HBc), which appears in the early stage of infection and is mostly present for life. Traditionally, the anti-HBc is regarded as an evidential serological marker of HBV infections. In the last ten years, several studies revealed the predictive value of quantitative anti-HBc (qAnti-HBc) level in the treatment response and clinical outcome of chronic HBV infections, implying new insights into this classic marker. Overall, qAnti-HBc should be regarded as an indicator of the host's immune response specific to HBV, which correlates with HBV-related hepatitis activity and liver pathology. This review summarized the latest understanding of the clinical values of qAnti-HBc for differentiating the CHB phase, predicting treatment response, and providing disease prognosis. Moreover, we also discussed the possible mechanism of qAnti-HBc regulation during different courses of HBV infection.
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Affiliation(s)
- Yang Shi
- State Key Laboratory of Infectious Disease Vaccine Development, Xiang An Biomedicine Laboratory, School of Public Health, Xiamen University, Xiamen 361102, China; (Y.S.); (Z.W.); (S.G.); (N.X.)
- NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, National Institute of Diagnostics Vaccine Development in Infectious Diseases, School of Public Health, Xiamen 361102, China
| | - Zihan Wang
- State Key Laboratory of Infectious Disease Vaccine Development, Xiang An Biomedicine Laboratory, School of Public Health, Xiamen University, Xiamen 361102, China; (Y.S.); (Z.W.); (S.G.); (N.X.)
- NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, National Institute of Diagnostics Vaccine Development in Infectious Diseases, School of Public Health, Xiamen 361102, China
| | - Shengxiang Ge
- State Key Laboratory of Infectious Disease Vaccine Development, Xiang An Biomedicine Laboratory, School of Public Health, Xiamen University, Xiamen 361102, China; (Y.S.); (Z.W.); (S.G.); (N.X.)
- NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, National Institute of Diagnostics Vaccine Development in Infectious Diseases, School of Public Health, Xiamen 361102, China
| | - Ningshao Xia
- State Key Laboratory of Infectious Disease Vaccine Development, Xiang An Biomedicine Laboratory, School of Public Health, Xiamen University, Xiamen 361102, China; (Y.S.); (Z.W.); (S.G.); (N.X.)
- NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, National Institute of Diagnostics Vaccine Development in Infectious Diseases, School of Public Health, Xiamen 361102, China
| | - Quan Yuan
- State Key Laboratory of Infectious Disease Vaccine Development, Xiang An Biomedicine Laboratory, School of Public Health, Xiamen University, Xiamen 361102, China; (Y.S.); (Z.W.); (S.G.); (N.X.)
- NMPA Key Laboratory for Research and Evaluation of Infectious Disease Diagnostic Technology, National Institute of Diagnostics Vaccine Development in Infectious Diseases, School of Public Health, Xiamen 361102, China
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Wang L, Liu S, Wang C, Zhu M, Guo Y, Zhao P. Hepatocyte proliferation favours viral clearance in young children with chronic hepatitis B virus infection. Acta Paediatr 2023; 112:305-310. [PMID: 36239417 DOI: 10.1111/apa.16572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/05/2022] [Accepted: 10/13/2022] [Indexed: 01/20/2023]
Abstract
AIM The aim of this study is to explore the correlation between hepatocyte proliferation and hepatitis B virus (HBV) clearance in young children with chronic HBV infection. METHODS We collected liver biopsy samples and clinical data corresponding to paediatric patients with chronic HBV infection. Ki-67 expression in liver tissues was evaluated by immunohistochemical staining. RESULTS Eighteen patients were included and were divided into two groups based on different antiviral outcomes. Group I achieved hepatitis B surface antigen (HBsAg) loss within 48 weeks. Group II did not develop seroconversion from hepatitis B e (HBe) antigen to anti-HBe after 48 weeks. There were 10 patients in Group I and 8 in Group II, respectively. Demographical data and baseline virological and biochemical characteristics in serum across Group I and Group II were not statistically different. Histologically, mean Ki-67 expression index in Group I was 15%, while the mean index in Group II was 5%. There was a significant difference between the two groups (p < 0.01). CONCLUSION High Ki-67 expression can contribute to viral clearance in young children with chronic HBV infection. This is the first confirmation of the association between hepatocyte proliferation and HBV clearance in vivo and has implications for novel therapeutic strategies against hepatitis B.
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Affiliation(s)
- Limin Wang
- Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China
| | - Shuhong Liu
- The Fifth Medical Center (formerly Beijing 302 Hospital), Chinese PLA General Hospital, Beijing, China
| | - Chunya Wang
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Min Zhu
- The Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yupeng Guo
- College of Public Health, Mudanjiang Medical University, Mudanjiang, China
| | - Pan Zhao
- The Fifth Medical Center (formerly Beijing 302 Hospital), Chinese PLA General Hospital, Beijing, China
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Clinical Utility of Quantitative HBV Core Antibodies for Solving Diagnostic Dilemmas. Viruses 2023; 15:v15020373. [PMID: 36851587 PMCID: PMC9965363 DOI: 10.3390/v15020373] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/20/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023] Open
Abstract
The present-day management of hepatitis B virus (HBV) infection relies on constant and appropriate monitoring of viral activity, disease progression and treatment response. Traditional HBV infection biomarkers have many limitations in predicting clinical outcomes or therapy success. Quantitation of HBV core antibodies (qAnti-HBc) is a new non-invasive biomarker that can be used in solving multiple diagnostic problems. It was shown to correlate well with infection phases, level of hepatic inflammation and fibrosis, exacerbations during chronic infection and presence of occult infection. Further, the level of qAnti-HBc was recognised as predictive of spontaneous or therapy-induced HBeAg and HBsAg seroclearance, relapse after therapy discontinuation, re-infection after liver transplantation and viral reactivation upon immunosuppression. However, qAnti-HBc cannot be relied upon as a single diagnostic test to solve all dilemmas, and its diagnostic and prognostic power can be much improved when combined with other diagnostic biomarkers (HBV DNA, HBeAg, qHBsAg and anti-HBs antibodies). The availability of commercial qAnti-HBc diagnostic kits still needs to be improved. The comparison of results from different studies and definitions of universal cut-off values continue to be hindered because many methods are only semi-quantitative. The clinical utility of qAnti-HBc and the methods used for its measurement are the focus of this review.
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Zheng JR, Wang ZL, Feng B. Hepatitis B functional cure and immune response. Front Immunol 2022; 13:1075916. [PMID: 36466821 PMCID: PMC9714500 DOI: 10.3389/fimmu.2022.1075916] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 11/02/2022] [Indexed: 07/30/2023] Open
Abstract
Hepatitis B virus (HBV) is a hepatotropic virus, which damage to hepatocytes is not direct, but through the immune system. HBV specific CD4+ T cells can induce HBV specific B cells and CD8+ T cells. HBV specific B cells produce antibodies to control HBV infection, while HBV specific CD8+ T cells destroy infected hepatocytes. One of the reasons for the chronicity of HBV infection is that it cannot effectively activate adoptive immunity and the function of virus specific immune cells is exhausted. Among them, virus antigens (including HBV surface antigen, e antigen, core antigen, etc.) can inhibit the function of immune cells and induce immune tolerance. Long term nucleos(t)ide analogues (NAs) treatment and inactive HBsAg carriers with low HBsAg level may "wake up" immune cells with abnormal function due to the decrease of viral antigen level in blood and liver, and the specific immune function of HBV will recover to a certain extent, thus becoming the "dominant population" for functional cure. In turn, the functional cure will further promote the recovery of HBV specific immune function, which is also the theoretical basis for complete cure of hepatitis B. In the future, the complete cure of chronic HBV infection must be the combination of three drugs: inhibiting virus replication, reducing surface antigen levels and specific immune regulation, among which specific immunotherapy is indispensable. Here we review the relationship, mechanism and clinical significance between the cure of hepatitis B and immune system.
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Affiliation(s)
| | | | - Bo Feng
- Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Peking University People’s Hospital, Peking University Hepatology Institute, Beijing, China
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Sonneveld MJ, Chiu SM, Chen CH, Maasoumy B. Reply to: "Probability of HBsAg loss after nucleos(t)ide analogue withdrawal depends on HBV genotype and viral antigen levels". J Hepatol 2022; 77:1224-1226. [PMID: 35810930 DOI: 10.1016/j.jhep.2022.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 06/30/2022] [Indexed: 12/04/2022]
Affiliation(s)
- Milan J Sonneveld
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - Shao-Ming Chiu
- Department of Internal Medicine, Koahsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chien-Hung Chen
- Department of Internal Medicine, Koahsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Benjamin Maasoumy
- Department of Gastroenterology and Hepatology, Hannover Medical School, Hannover, Germany
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