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Liu Y, Wu D, Zhang K, Ren R, Liu Y, Zhang S, Zhang X, Cheng J, Chen L, Huang J. Detection technology and clinical applications of serum viral products of hepatitis B virus infection. Front Cell Infect Microbiol 2024; 14:1402001. [PMID: 39035352 PMCID: PMC11257880 DOI: 10.3389/fcimb.2024.1402001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 06/12/2024] [Indexed: 07/23/2024] Open
Abstract
Viral hepatitis, caused by its etiology, hepatitis virus, is a public health problem globally. Among all infections caused by hepatitis-associated viruses, hepatitis B virus (HBV) infection remains the most serious medical concern. HBV infection particularly affects people in East Asia and Africa, the Mediterranean region, and Eastern Europe, with a prevalence rate of > 2%. Currently, approximately 1 billion people worldwide are infected with HBV, and nearly 30% of them experience chronic infection. Chronic HBV infection can lead to chronic hepatitis B (CHB), liver cirrhosis, and hepatocellular carcinoma (HCC), resulting in the related death of approximately 1 million people annually. Although preventative vaccines and antiviral therapies are currently available, there is no cure for this infection. Clinical testing is not only the gateway for diagnosis of HBV infection, but also crucial for judging the timing of medication, evaluating the effect of antiviral therapy, and predicting the risk of relapse after drug withdrawal in the whole follow-up management of hepatitis B infected persons. With advances in detection technology, it is now possible to measure various viral components in the blood to assess the clinical status of HBV infection. Serum viral products of HBV infection, such as HBV DNA, HBV RNA, hepatitis B surface antigen, hepatitis B e-antigen, and hepatitis B core-related antigen, are non-invasive indicators that are critical for the rapid diagnosis and management of related diseases. Improving the sensitivity of monitoring of these products is essential, and the development of corresponding detection technologies is pivotal in achieving this goal. This review aims to offer valuable insights into CHB infection and references for its effective treatment. We provide a comprehensive and systematic overview of classical and novel methods for detecting HBV serum viral products and discusses their clinical applications, along with the latest research progress in this field.
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Affiliation(s)
- Ying Liu
- School of Life Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Di Wu
- School of Life Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Kui Zhang
- State Key Laboratory of Resource Insects, College of Sericulture, Textile and Biomass Sciences, Southwest University, Chongqing, China
| | - Rongrong Ren
- Department of Clinical Laboratory, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Yuxuan Liu
- School of Life Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Shuya Zhang
- School of Life Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Xuanyu Zhang
- School of Life Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Jilin Cheng
- Department of Gastroenterology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Liping Chen
- Department of Gastroenterology, Shanghai Geriatric Medical Center, Shanghai, China
| | - Jun Huang
- School of Life Sciences, Zhengzhou University, Zhengzhou, Henan, China
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Boglione L, Lupia T, Stroffolini G, Dodaro V, Perri GD. HBsAg kinetics after 7 years of therapy with tenofovir disoproxil fumarate in a cohort of naïve patients affected by chronic hepatitis B with different genotypes. INFECTIOUS MEDICINE 2024; 3:100087. [PMID: 38450105 PMCID: PMC10915551 DOI: 10.1016/j.imj.2024.100087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/05/2023] [Accepted: 12/12/2023] [Indexed: 03/08/2024]
Abstract
The role of different genotypes in nucleos(t)ide analogs (NAs) treatment is still debated. Previous studies conducted on special populations evidenced that the E genotype had the lower virological and serological response. This descriptive study aims to recognize the hepatitis B "s" antigen (HBsAg) decline during tenofovir disoproxil fumarate (TDF) treatment in a cohort of patient affected by chronic hepatitis B (CHB). We retrospectively included all patients with CHB treated with TDF between April 2007 and March 2012 with a duration of treatment of 7 years. Kinetics of HBsAg was determined as serological response in this cohort. We include 110 subjects; virological response was observed in all subjects with genotypes A, B, and D; in 17 patients with C genotype (94.4%) and 24 with E genotype (96%). HBeAg loss was observed in 2 patients with genotype A (50%), 3 with B (100%), 0 with C (0%), 1 with D (20%), and 1 with E genotype (25%). In multivariate analysis we observed as predictive factors of HBsAg decline the baseline level of HBsAg (OR = 1.467; 95%CI: 1.221-5.113; p = 0.017) and viral genotypes (OR = 11.218; 95%CI: 5.441-41.138; p < 0.001). This study confirmed higher HBsAg decline after 7 years of treatment in A and B genotypes, and lower in C, E, and D genotypes. However, no evidence is enough to choose a single NAs, but in special populations, as well as in genotype E, the use of TDF should be preferred to entecavir.
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Affiliation(s)
- Lucio Boglione
- Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy
| | - Tommaso Lupia
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10138 Turin, Italy
| | - Giacomo Stroffolini
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10138 Turin, Italy
| | - Valentina Dodaro
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10138 Turin, Italy
| | - Giovanni Di Perri
- Department of Medical Sciences, Infectious Diseases, University of Turin, 10138 Turin, Italy
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3
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Roade L, Riveiro-Barciela M, Pfefferkorn M, Sopena S, Palom A, Bes M, Rando-Segura A, Casillas R, Tabernero D, Rodríguez-Frías F, Berg T, Esteban R, van Bömmel F, Buti M. HBsAg protein composition and clinical outcomes in chronic hepatitis D and variations across HBeAg-negative chronic HBsAg carriers. JHEP Rep 2023; 5:100842. [PMID: 37745192 PMCID: PMC10514556 DOI: 10.1016/j.jhepr.2023.100842] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/25/2023] [Accepted: 06/24/2023] [Indexed: 09/26/2023] Open
Abstract
Background & Aims HBsAg proteins are useful to identify HBV inactive carriers (ICs), but data on chronic hepatitis D (CHD) are scarce. This study aimed to describe HBsAg composition in CHD, its changes during the evolution, and the potential association with clinical outcomes. In addition, we assess the composition of HBsAg across different HBV genotypes and validate previous results on HBsAg proteins in an independent HBV cohort. Methods Quantitative HBsAg, medium HBsAg proteins (MHBs), and large HBsAg proteins (LHBs) were measured in two cohorts. The first cohort consisted of patients with CHD. A cross-sectional study of samples from two European institutions (N = 46) was conducted. Outcomes were assessed in a retrospective-prospective study of those patients with a follow-up of >1 year (n = 36), and the longitudinal evolution of HBsAg proteins in those with samples >5 years apart (n = 12) was analysed. The second cohort consisted of patients with HBeAg-negative HBV, and a cross-sectional study was performed (N = 141). Results Forty-one (89%) patients with CHD had detectable HDV-RNA, and the presence of HDV-RNA was associated with higher LHBs proportion (p = 0.010). Baseline MHBs (p = 0.051) and MHBs proportion (p = 0.086) tended to be higher in those developing clinical outcomes (9/36, 25%) after a median follow-up of 5.9 years. Patients in which HDV-RNA became spontaneously undetectable during follow-up (5/31, 16.1%) tended to present lower MHBs proportion (p = 0.085). In the longitudinal study, changes in LHBs proportion were observed (p = 0.041), whereas MHBs proportion remained stable (p = 0.209). Regarding HBV, ICs showed lower LHBs proportion (p = 0.027). LHBs and MHBs differed significantly according to HBV genotype, regardless of the HBV phase. Conclusions Patients with CHD with detectable HDV-RNA presented higher LHBs proportion than those with undetectable HDV-RNA. A trend toward having higher baseline MHBs proportion was observed in patients who developed clinical outcomes or remained with detectable HDV-RNA. This study validates the different HBsAg composition in HBV ICs and reveals the HBV-genotype influence in HBsAg composition. Impact and implications The composition of HBsAg in chronic hepatitis D differs in patients with detectable and undetectable HDV viral load and may help predict the likelihood of achieving undetectable HDV viraemia and the development of clinical events such as decompensation. The composition of the surface antigen is also useful to distinguish inactive carriers of HBV, and it varies according to HBV genotype.
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Affiliation(s)
- Luisa Roade
- Universitat Autònoma de Barcelona (UAB), Department of Medicine, Barcelona, Spain
- Liver Unit, Internal Medicine Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Mar Riveiro-Barciela
- Universitat Autònoma de Barcelona (UAB), Department of Medicine, Barcelona, Spain
- Liver Unit, Internal Medicine Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Maria Pfefferkorn
- Division of Hepatology, Department of Medicine, Leipzig University Medical Center, Leipzig, Germany
| | - Sara Sopena
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Liver Pathology Lab, Biochemistry and Microbiology Departments (Clinical Laboratories), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Adriana Palom
- Universitat Autònoma de Barcelona (UAB), Department of Medicine, Barcelona, Spain
- Liver Unit, Internal Medicine Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Bes
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Transfusion Safety Laboratory, Banc de Sang i Teixits, Servei Català de la Salut, Barcelona, Spain
| | - Ariadna Rando-Segura
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Liver Pathology Lab, Biochemistry and Microbiology Departments (Clinical Laboratories), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Rosario Casillas
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Liver Pathology Lab, Biochemistry and Microbiology Departments (Clinical Laboratories), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - David Tabernero
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Liver Pathology Lab, Biochemistry and Microbiology Departments (Clinical Laboratories), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Universitat Autònoma de Barcelona (UAB), Department of Biochemistry and Molecular Biology, Barcelona, Spain
- Liver Diseases-Viral Hepatitis, Liver Unit, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Francisco Rodríguez-Frías
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Liver Pathology Lab, Biochemistry and Microbiology Departments (Clinical Laboratories), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Universitat Autònoma de Barcelona (UAB), Department of Biochemistry and Molecular Biology, Barcelona, Spain
- Liver Diseases-Viral Hepatitis, Liver Unit, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Thomas Berg
- Division of Hepatology, Department of Medicine, Leipzig University Medical Center, Leipzig, Germany
| | - Rafael Esteban
- Universitat Autònoma de Barcelona (UAB), Department of Medicine, Barcelona, Spain
- Liver Unit, Internal Medicine Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Florian van Bömmel
- Division of Hepatology, Department of Medicine, Leipzig University Medical Center, Leipzig, Germany
| | - María Buti
- Universitat Autònoma de Barcelona (UAB), Department of Medicine, Barcelona, Spain
- Liver Unit, Internal Medicine Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
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Thiyagarajah K, Basic M, Hildt E. Cellular Factors Involved in the Hepatitis D Virus Life Cycle. Viruses 2023; 15:1687. [PMID: 37632029 PMCID: PMC10459925 DOI: 10.3390/v15081687] [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: 06/30/2023] [Revised: 07/30/2023] [Accepted: 08/01/2023] [Indexed: 08/27/2023] Open
Abstract
Hepatitis D virus (HDV) is a defective RNA virus with a negative-strand RNA genome encompassing less than 1700 nucleotides. The HDV genome encodes only for one protein, the hepatitis delta antigen (HDAg), which exists in two forms acting as nucleoproteins. HDV depends on the envelope proteins of the hepatitis B virus as a helper virus for packaging its ribonucleoprotein complex (RNP). HDV is considered the causative agent for the most severe form of viral hepatitis leading to liver fibrosis/cirrhosis and hepatocellular carcinoma. Many steps of the life cycle of HDV are still enigmatic. This review gives an overview of the complete life cycle of HDV and identifies gaps in knowledge. The focus is on the description of cellular factors being involved in the life cycle of HDV and the deregulation of cellular pathways by HDV with respect to their relevance for viral replication, morphogenesis and HDV-associated pathogenesis. Moreover, recent progress in antiviral strategies targeting cellular structures is summarized in this article.
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Affiliation(s)
| | | | - Eberhard Hildt
- Paul-Ehrlich-Institute, Department of Virology, D-63225 Langen, Germany; (K.T.); (M.B.)
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Relevance of HBx for Hepatitis B Virus-Associated Pathogenesis. Int J Mol Sci 2023; 24:ijms24054964. [PMID: 36902395 PMCID: PMC10003785 DOI: 10.3390/ijms24054964] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/20/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
The hepatitis B virus (HBV) counts as a major global health problem, as it presents a significant causative factor for liver-related morbidity and mortality. The development of hepatocellular carcinomas (HCC) as a characteristic of a persistent, chronic infection could be caused, among others, by the pleiotropic function of the viral regulatory protein HBx. The latter is known to modulate an onset of cellular and viral signaling processes with emerging influence in liver pathogenesis. However, the flexible and multifunctional nature of HBx impedes the fundamental understanding of related mechanisms and the development of associated diseases, and has even led to partial controversial results in the past. Based on the cellular distribution of HBx-nuclear-, cytoplasmic- or mitochondria-associated-this review encompasses the current knowledge and previous investigations of HBx in context of cellular signaling pathways and HBV-associated pathogenesis. In addition, particular focus is set on the clinical relevance and potential novel therapeutic applications in the context of HBx.
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Roade L, Riveiro-Barciela M, Palom A, Rodríguez-Frías F, Bes M, Rando A, Salcedo MT, Casillas R, Vargas-Accarino E, Tabernero D, Sauleda S, Esteban R, Buti M. ACE Score Identifies HBeAg-negative Inactive Carriers at a Single-point Evaluation, Regardless of HBV Genotype. J Clin Transl Hepatol 2022; 10:1068-1076. [PMID: 36381089 PMCID: PMC9634781 DOI: 10.14218/jcth.2022.00068] [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: 02/09/2022] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND AND AIMS Hepatitis B virus (HBV) biomarkers have been used for a better categorization of patients, even though the lack of simple algorithms and the impact of genotypes limit their application. Our aim was to assess the usefulness of noninvasive markers for the identification of HBV inactive carriers (ICs) in a single-point evaluation and to design a predictive model for their identification. METHODS This retrospective-prospective study included 343 consecutive HBeAg-negative individuals. Clinical, analytical, and virological data were collected, and a liver biopsy was performed if needed. Subjects were classified at the end of follow-up as ICs, chronic hepatitis B and gray zone.A predictive model was constructed, and validated by 1000-bootstrap samples. RESULTS After 39 months of follow-up, 298 subjects were ICs, 36 were chronic hepatitis B CHB, and nine were gray zone. Eighty-nine (25.9%) individuals required a liver biopsy. Baseline HBV DNA hazard ratio (HR) 6.0, p<0.001), HBV core-related antigen (HBcrAg) (HR 6.5, p<0.001), and elastography (HR 4.6, p<0.001) were independently associated with the IC stage. The ACE score (HBV DNA, HBcrAg, elastography), obtained by bootstrapping, yielded an area under the receiver operating characteristics (AUROC) of 0.925 (95% CI: 0.880-0.970, p<0.001) for identification of ICs. The AUROC for genotype D was 0.95, 0.96 for A, 0.90 for E, and 0.88 for H/F. An ACE score of <1 had a positive predictive value of 99.5%, and a score ≤12 points had a diagnostic accuracy of 93.8%. CONCLUSIONS Low baseline HBV DNA, HBcrAg, and liver stiffness were independently associated with the IC phase. A score including those variables identified ICs at a single-point evaluation, and might be applied to implement less intensive follow-up strategies.
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Affiliation(s)
- Luisa Roade
- Liver Unit, Internal Medicine Department, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
- Universitat Autònoma de Barcelona (UAB), Department of Medicine, Barcelona, Spain
- Universitat Autònoma de Barcelona (UAB), Department of Biochemistry and Molecular Biology, Barcelona, Spain
| | - Mar Riveiro-Barciela
- Liver Unit, Internal Medicine Department, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
- Universitat Autònoma de Barcelona (UAB), Department of Medicine, Barcelona, Spain
- Universitat Autònoma de Barcelona (UAB), Department of Biochemistry and Molecular Biology, Barcelona, Spain
- Correspondence to: Mar Riveiro-Barciela, Passeig de la Vall d’Hebron 119-129, 08035, Barcelona, Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d’Hebron, Barcelona, Spain. ORCID: https://orcid.org/0000-0001-9309-2052. Tel: +93-4893030-6559, Fax: +93-4894032, E-Mail:
| | - Adriana Palom
- Universitat Autònoma de Barcelona (UAB), Department of Medicine, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Francisco Rodríguez-Frías
- Universitat Autònoma de Barcelona (UAB), Department of Biochemistry and Molecular Biology, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Liver Pathology Lab, Biochemistry and Microbiology Departments (Clinical Laboratories), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Marta Bes
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Vall d’Hebron Institut de Recerca (VHIR), Liver Diseases Group, Barcelona, Spain
- Transfusion Safety Laboratory, Banc de Sang i Teixits, Servei Català de la Salut, Barcelona, Spain
| | - Ariadna Rando
- Universitat Autònoma de Barcelona (UAB), Department of Biochemistry and Molecular Biology, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Liver Pathology Lab, Biochemistry and Microbiology Departments (Clinical Laboratories), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - María Teresa Salcedo
- Department of Pathology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rosario Casillas
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Liver Pathology Lab, Biochemistry and Microbiology Departments (Clinical Laboratories), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Elena Vargas-Accarino
- Universitat Autònoma de Barcelona (UAB), Department of Biochemistry and Molecular Biology, Barcelona, Spain
- Vall d’Hebron Institut de Recerca (VHIR), Liver Diseases Group, Barcelona, Spain
| | - David Tabernero
- Universitat Autònoma de Barcelona (UAB), Department of Biochemistry and Molecular Biology, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Liver Pathology Lab, Biochemistry and Microbiology Departments (Clinical Laboratories), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Silvia Sauleda
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
- Vall d’Hebron Institut de Recerca (VHIR), Liver Diseases Group, Barcelona, Spain
- Transfusion Safety Laboratory, Banc de Sang i Teixits, Servei Català de la Salut, Barcelona, Spain
| | - Rafael Esteban
- Liver Unit, Internal Medicine Department, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
- Universitat Autònoma de Barcelona (UAB), Department of Medicine, Barcelona, Spain
- Universitat Autònoma de Barcelona (UAB), Department of Biochemistry and Molecular Biology, Barcelona, Spain
| | - María Buti
- Liver Unit, Internal Medicine Department, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
- Universitat Autònoma de Barcelona (UAB), Department of Medicine, Barcelona, Spain
- Universitat Autònoma de Barcelona (UAB), Department of Biochemistry and Molecular Biology, Barcelona, Spain
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Fu Y, Fang F, Guo H, Xiao X, Hu Y, Zeng Y, Chen T, Wu S, Lin N, Huang J, Jiang L, Ou Q, Liu C. Compartmentalisation of Hepatitis B virus X gene evolution in hepatocellular carcinoma microenvironment and the genotype-phenotype correlation of tumorigenicity in HBV-related patients with hepatocellular carcinoma. Emerg Microbes Infect 2022; 11:2486-2501. [PMID: 36102940 PMCID: PMC9621239 DOI: 10.1080/22221751.2022.2125344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/26/2022] [Accepted: 09/12/2022] [Indexed: 02/08/2023]
Abstract
Hepatitis B virus (HBV) exists as quasispecies (QS). However, the evolutionary characteristics of haplotypes of HBV X gene in the hepatocellular carcinoma (HCC) microenvironment remain unclear. Mutations across X gene are essential for the tumorigenicity of HBV X protein (HBx). However, the functional phenotypes of many mutant HBx remain unknown. This study aims to compare the characteristics of X gene evolution between tumour and non-tumour tissues in HCC patients and investigate the tumorigenic phenotype of HBx harbouring mutation T81P/S101P/L123S. This study included 24 HCC patients. Molecular cloning of X gene was performed to analyse characteristics of haplotypes in liver tissues. HCC cell lines stably expressing wild-type or mutant HBx and subcutaneous tumour xenograft mouse model were used to assess HBx-T81P/S101P/L123S tumorigenicity. The mean heterogeneity of HBV QS across X gene in tumour tissues was lower than that in non-tumour tissues. A location bias was observed in X gene clones with genotype C or D in tumour tissues compared to those with genotype B. Mutations in genotype-C or - D clones were mainly clustered in the dimerization region and aa110-aa140 within the transactivation region. A novel mutation combination at residues 81, 101 and 123 was identified in tumour tissues. Further, HBx-T81P/S101P/L123S promotes cell proliferation and increases genomic instability, which was mediated by MYC. This study elucidates the compartmentalized evolution patterns of HBV X gene between intra tumour and non-tumour tissues in HCC patients and provides a new mechanism underlying HBV-driven hepatocarcinogenesis, suggesting a potential viral marker for monitoring HCC.
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Affiliation(s)
- Ya Fu
- Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Clinical Laboratory Diagnostics, The First Clinical College, Fujian Medical University, Fuzhou, People’s Republic of China
- Fujian Key Laboratory of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Gene Diagnosis Research Center, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Fengling Fang
- Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Clinical Laboratory Diagnostics, The First Clinical College, Fujian Medical University, Fuzhou, People’s Republic of China
- Fujian Key Laboratory of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Gene Diagnosis Research Center, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Hongyan Guo
- Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Clinical Laboratory Diagnostics, The First Clinical College, Fujian Medical University, Fuzhou, People’s Republic of China
- Fujian Key Laboratory of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Gene Diagnosis Research Center, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Xialin Xiao
- Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Clinical Laboratory Diagnostics, The First Clinical College, Fujian Medical University, Fuzhou, People’s Republic of China
- Fujian Key Laboratory of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Gene Diagnosis Research Center, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Yuhai Hu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Yongbin Zeng
- Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Clinical Laboratory Diagnostics, The First Clinical College, Fujian Medical University, Fuzhou, People’s Republic of China
- Fujian Key Laboratory of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Gene Diagnosis Research Center, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Tianbin Chen
- Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Clinical Laboratory Diagnostics, The First Clinical College, Fujian Medical University, Fuzhou, People’s Republic of China
- Fujian Key Laboratory of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Gene Diagnosis Research Center, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Songhang Wu
- Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Clinical Laboratory Diagnostics, The First Clinical College, Fujian Medical University, Fuzhou, People’s Republic of China
- Fujian Key Laboratory of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Gene Diagnosis Research Center, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Ni Lin
- Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Clinical Laboratory Diagnostics, The First Clinical College, Fujian Medical University, Fuzhou, People’s Republic of China
- Fujian Key Laboratory of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Gene Diagnosis Research Center, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Jinlan Huang
- Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Clinical Laboratory Diagnostics, The First Clinical College, Fujian Medical University, Fuzhou, People’s Republic of China
- Fujian Key Laboratory of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Gene Diagnosis Research Center, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Ling Jiang
- Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Clinical Laboratory Diagnostics, The First Clinical College, Fujian Medical University, Fuzhou, People’s Republic of China
- Fujian Key Laboratory of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Gene Diagnosis Research Center, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Qishui Ou
- Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Clinical Laboratory Diagnostics, The First Clinical College, Fujian Medical University, Fuzhou, People’s Republic of China
- Fujian Key Laboratory of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Gene Diagnosis Research Center, Fujian Medical University, Fuzhou, People’s Republic of China
- Qishui Ou Department of Laboratory Medicine, The First Affiliated Hospital, Clinical Laboratory Diagnostics, The First Clinical College, Fujian Key Laboratory of Laboratory Medicine, The First Affiliated Hospital, Gene Diagnosis Research Center, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Can Liu
- Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Clinical Laboratory Diagnostics, The First Clinical College, Fujian Medical University, Fuzhou, People’s Republic of China
- Fujian Key Laboratory of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Gene Diagnosis Research Center, Fujian Medical University, Fuzhou, People’s Republic of China
- Can Liu Department of Laboratory Medicine, The First Affiliated Hospital, Clinical Laboratory Diagnostics, The First Clinical College, Fujian Key Laboratory of Laboratory Medicine, The First Affiliated Hospital, Gene Diagnosis Research Center, Fujian Medical University, Fuzhou, People’s Republic of China
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8
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Eymieux S, Hourioux C, Marlet J, Moreau A, Patient R, d'Alteroche L, Gaudy‐Graffin C, Blanchard E, Roingeard P. A morphometric analysis of hepatitis B subviral particles shows no correlation of filament proportion and length with clinical stage and genotype. J Viral Hepat 2022; 29:719-726. [PMID: 35633087 PMCID: PMC9541738 DOI: 10.1111/jvh.13712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/11/2022] [Accepted: 05/04/2022] [Indexed: 12/09/2022]
Abstract
It was recently suggested that the composition of circulating hepatitis B subviral particles (SVPs) could be used to differentiate the various stages in chronic hepatitis B virus (HBV) infection, with significantly lower proportions of L and M proteins in inactive carriers than in individuals with chronic hepatitis. L protein is abundant in virions and filamentous SVPs but almost absent from spherical SVPs. We, therefore, performed a morphometric analysis of SVPs in these two groups of patients, by conducting a retrospective analysis on sera from 15 inactive carriers and 11 patients with chronic hepatitis infected with various HBV genotypes. Subviral particles were concentrated by centrifugation on a sucrose cushion, with monitoring by transmission electron microscopy. The percentage of filamentous SVPs and filament length for 100 SVPs was determined with a digital camera. The L protein PreS1 promoter was sequenced from viral genomes by the Sanger method. No marked differences were found between patients, some of whom had only spherical SVPs, whereas others had variable percentages of filamentous SVPs (up to 28%), of highly variable length. High filament percentages were not associated with a particular sequence of the L protein promoter, HBV genotype or even disease stage. High levels of circulating filamentous SVPs are probably more strongly related to individual host factors than to viral strain characteristics or disease stage.
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Affiliation(s)
- Sébastien Eymieux
- INSERM U1259 MAVIVHUniversité de Tours and CHRU de ToursToursFrance,Plate‐Forme IBiSA de Microscopie ElectroniqueUniversité de Tours and CHRU de ToursToursFrance
| | - Christophe Hourioux
- INSERM U1259 MAVIVHUniversité de Tours and CHRU de ToursToursFrance,Plate‐Forme IBiSA de Microscopie ElectroniqueUniversité de Tours and CHRU de ToursToursFrance
| | - Julien Marlet
- INSERM U1259 MAVIVHUniversité de Tours and CHRU de ToursToursFrance,Service de Bactériologie‐Virologie‐HygièneCHRU de ToursToursFrance
| | - Alain Moreau
- INSERM U1259 MAVIVHUniversité de Tours and CHRU de ToursToursFrance
| | - Romuald Patient
- INSERM U1259 MAVIVHUniversité de Tours and CHRU de ToursToursFrance
| | - Louis d'Alteroche
- Unité d'Hépatologie, Service d'HépatogastroentérologieCHRU de ToursToursFrance
| | - Catherine Gaudy‐Graffin
- INSERM U1259 MAVIVHUniversité de Tours and CHRU de ToursToursFrance,Service de Bactériologie‐Virologie‐HygièneCHRU de ToursToursFrance
| | - Emmanuelle Blanchard
- INSERM U1259 MAVIVHUniversité de Tours and CHRU de ToursToursFrance,Plate‐Forme IBiSA de Microscopie ElectroniqueUniversité de Tours and CHRU de ToursToursFrance
| | - Philippe Roingeard
- INSERM U1259 MAVIVHUniversité de Tours and CHRU de ToursToursFrance,Plate‐Forme IBiSA de Microscopie ElectroniqueUniversité de Tours and CHRU de ToursToursFrance
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9
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Broquetas T, Hernandez JJ, Garcia-Retortillo M, Canillas L, Puigvehí M, Cañete N, Coll S, Viu A, Garrido E, Mico M, Bessa X, Carrión JA. On-therapy HBsAg kinetics can predict HBsAg loss after nucleos(t)ide analogues interruption in HBeAg-negative patients. The cup is half full and half empty. Dig Liver Dis 2022; 54:1044-1051. [PMID: 35063365 DOI: 10.1016/j.dld.2021.12.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/25/2021] [Accepted: 12/29/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Nucleos(t)ide analogues withdrawal may improve HBsAg loss rates. However, conditions to select patients are not well established. AIMS to evaluate the impact of HBsAg kinetics before treatment interruption on post-treatment response. METHODS Longitudinal, ambispective study in non-cirrhotic chronic hepatitis B HBeAg-negative patients, analysing on-treatment and post-treatment HBsAg kinetics. On-treatment HBsAg kinetics diagnostic accuracy (AUROC) to identify HBsAg loss was evaluated. RESULTS 52 HBeAg-negative patients stopped treatment after 8.2 years, and 6 (11.5%) achieved HBsAg loss one year after withdrawal. Multivariate analysis showed that on-treatment HBsAg kinetics was related to HBsAg loss (OR=0.10; 95%CI=0.016-0.632; p = 0.014) with a high diagnostic accuracy (AUROC=0.935). A significant HBsAg decline ≥1 log10 IU/mL showed a positive and negative predictive value of 50% and of 97.6%, respectively. After treatment interruption, HBsAg decline speed (log10 IU/mL/year) accelerated in patients treated >6 years (from -0.06 to -0.20, p<0.05) and remained stable in treated <6 years (from -0.12 to -0.12 p=ns). CONCLUSIONS On-treatment HBsAg kinetics can predict post-treatment HBsAg loss rate. Half of patients with a significant HBsAg decline can eliminate HBsAg the first year after withdrawal. Post-treatment HBsAg decline is faster not only in patients who lost the HBsAg but also in those who remain HBsAg-positive.
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Affiliation(s)
- Teresa Broquetas
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain; Liver Section, Gastroenterology Department, Hospital del Mar, 25-29 Passeig Marítim, Barcelona 08003, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | | | - Montserrat Garcia-Retortillo
- Liver Section, Gastroenterology Department, Hospital del Mar, 25-29 Passeig Marítim, Barcelona 08003, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Lidia Canillas
- Liver Section, Gastroenterology Department, Hospital del Mar, 25-29 Passeig Marítim, Barcelona 08003, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Marc Puigvehí
- Liver Section, Gastroenterology Department, Hospital del Mar, 25-29 Passeig Marítim, Barcelona 08003, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Nuria Cañete
- Liver Section, Gastroenterology Department, Hospital del Mar, 25-29 Passeig Marítim, Barcelona 08003, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Susanna Coll
- Liver Section, Gastroenterology Department, Hospital del Mar, 25-29 Passeig Marítim, Barcelona 08003, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Ana Viu
- Liver Section, Gastroenterology Department, Hospital del Mar, 25-29 Passeig Marítim, Barcelona 08003, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Esther Garrido
- Liver Section, Gastroenterology Department, Hospital del Mar, 25-29 Passeig Marítim, Barcelona 08003, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Miquel Mico
- Laboratori de Referència de Catalunya, El Prat de Llobregat, Spain
| | - Xavier Bessa
- Liver Section, Gastroenterology Department, Hospital del Mar, 25-29 Passeig Marítim, Barcelona 08003, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - José A Carrión
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain; Liver Section, Gastroenterology Department, Hospital del Mar, 25-29 Passeig Marítim, Barcelona 08003, Spain.
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10
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Lai X, Chen W, Wu Y, Gao Y, Zhang Y, Xu X, Fu Y, Wang X, Yang Y, Zhang Y. Effect of mutations across reverse transcriptase region on HBV replication and progression of liver diseases in Chinese patients. J Clin Lab Anal 2022; 36:e24530. [PMID: 35657116 PMCID: PMC9279987 DOI: 10.1002/jcla.24530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 05/05/2022] [Accepted: 05/19/2022] [Indexed: 11/06/2022] Open
Abstract
It was known that mutations in the RT region were mainly related to nucleot(s)ide analogs resistance. Increasing studies indicated that RT mutations were related to advanced liver diseases (ALD) and had effects on HBV replication, but the distribution characteristics of mutations across RT region in the development of liver diseases and the effect of RT mutations on HBV replication were not fully clarified. HBV RT region was direct-sequenced in 1473 chronic HBV-infected patients. Mutation frequencies were analyzed to identify the specific mutations differing between groups classified by genotypes, loads of HBV DNA, or progression of liver diseases. In the range of rt145-rt290, rt145, rt221, rt222, rt267, and rt271 were the genotype-polymorphic sites, while rt238 was the genotype-specific sites. Mutations at rt163, rt173, rt180, rt181, rt184, rt191, rt199, and rt214 were more frequent among patients with C-genotype HBV, while those at rt220, rt225, rt226, rt269, and rt274 were more frequent among patients with B-genotype HBV. RtM204V/I could reduce the HBV DNA loads while rtQ/L267H/R could increase the HBV DNA loads. RtV214A/E/I (OR 3.94, 95% CI 1.09 to 14.26) was an independent risk factor for advanced liver diseases. In summary, the hotspots of mutations were different between B and C genotypes. Besides the effect on the S region, RT mutations had effects on HBV replication by other unknown ways. RtV214A/E/I was found to be an independent risk factor for ALD, suggesting that mutations at rt214 site could be used as a potential virological marker for the liver disease progression.
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Affiliation(s)
- Xiaoqin Lai
- Pharmacy DepartmentThe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
| | - Wenfa Chen
- Pharmacy DepartmentThe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
| | - Yuzhu Wu
- Pharmacy DepartmentThe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
| | - Yali Gao
- Pharmacy DepartmentThe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
| | - Yalan Zhang
- Pharmacy DepartmentThe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
| | - Xuwei Xu
- Pharmacy DepartmentThe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
| | - Ya Fu
- Department of Clinical LaboratoryThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Xinwen Wang
- Department of OrthopedicsSouthern Medical UniversityGuangzhouChina
| | - Yanbing Yang
- Department of ImagingMengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhouChina
| | - Yin Zhang
- Pharmacy DepartmentThe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
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11
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Fainboim H, Di Benedetto N, Paz S, Mendizabal M, Campuzano S, Elizalde M, Tadey L, Deluchi G, Bouzas MB, Mammana L, Flichman D. Quantitative HBsAg an unreliable marker for diagnosis and disease progression in genotype F chronic HBeAg-negative infections. J Viral Hepat 2022; 29:298-301. [PMID: 35152530 DOI: 10.1111/jvh.13657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 02/01/2022] [Indexed: 12/09/2022]
Affiliation(s)
- Hugo Fainboim
- Unidad de Hepatopatías Infecciosas, Hospital de Infecciosas F. J. Muñiz, Buenos Aires, Argentina
| | | | - Silvia Paz
- Unidad de Hepatopatías Infecciosas, Hospital de Infecciosas F. J. Muñiz, Buenos Aires, Argentina
| | | | - Soledad Campuzano
- Unidad de Hepatopatías Infecciosas, Hospital de Infecciosas F. J. Muñiz, Buenos Aires, Argentina
| | - Mercedes Elizalde
- Instituto de Investigaciones Biomédicas en Retrovirus y Síndrome de Inmunodeficiencia Adquirida (INBIRS), Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Luciana Tadey
- Unidad de Virología, Hospital de Infecciosas "Francisco J. Muñiz", Buenos Aires, Argentina
| | - Gabriel Deluchi
- Unidad de Virología, Hospital de Infecciosas "Francisco J. Muñiz", Buenos Aires, Argentina
| | - María Belén Bouzas
- Unidad de Virología, Hospital de Infecciosas "Francisco J. Muñiz", Buenos Aires, Argentina
| | - Lilia Mammana
- Unidad de Virología, Hospital de Infecciosas "Francisco J. Muñiz", Buenos Aires, Argentina
| | - Diego Flichman
- Instituto de Investigaciones Biomédicas en Retrovirus y Síndrome de Inmunodeficiencia Adquirida (INBIRS), Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
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12
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Pisano MB, Giadans CG, Flichman DM, Ré VE, Preciado MV, Valva P. Viral hepatitis update: Progress and perspectives. World J Gastroenterol 2021; 27:4018-4044. [PMID: 34326611 PMCID: PMC8311538 DOI: 10.3748/wjg.v27.i26.4018] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/11/2021] [Accepted: 06/16/2021] [Indexed: 02/06/2023] Open
Abstract
Viral hepatitis, secondary to infection with hepatitis A, B, C, D, and E viruses, are a major public health problem and an important cause of morbidity and mortality. Despite the huge medical advances achieved in recent years, there are still points of conflict concerning the pathogenesis, immune response, development of new and more effective vaccines, therapies, and treatment. This review focuses on the most important research topics that deal with issues that are currently being solved, those that remain to be solved, and future research directions. For hepatitis A virus we will address epidemiology, molecular surveillance, new susceptible populations as well as environmental and food detections. In the case of hepatitis B virus, we will discuss host factors related to disease, diagnosis, therapy, and vaccine improvement. On hepatitis C virus, we will focus on pathogenesis, immune response, direct action antivirals treatment in the context of solid organ transplantation, issues related to hepatocellular carcinoma development, direct action antivirals resistance due to selection of resistance-associated variants, and vaccination. Regarding hepatitis D virus, we describe diagnostic methodology, pathogenesis, and therapy. Finally, for hepatitis E virus, we will address epidemiology (including new emerging species), diagnosis, clinical aspects, treatment, the development of a vaccine, and environmental surveillance.
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Affiliation(s)
- María B Pisano
- Virology Institute, CONICET, School of Medical Sciences, National University of Córdoba, Cordoba X5016, Argentina
| | - Cecilia G Giadans
- Multidisciplinary Institute for Investigation in Pediatric Pathologies (IMIPP) CONICET-GCBA, Laboratory of Molecular Biology, Pathology Division, Ricardo Gutiérrez Children’s Hospital, CABA C1425, Buenos Aires, Argentina
| | - Diego M Flichman
- Institute of Biomedical Investigations in Retrovirus and AIDS (INBIRS), School of Medicine, University of Buenos Aires, CONICET, CABA C1121ABG, Buenos Aires, Argentina
| | - Viviana E Ré
- Virology Institute, CONICET, School of Medical Sciences, National University of Córdoba, Cordoba X5016, Argentina
| | - María V Preciado
- Multidisciplinary Institute for Investigation in Pediatric Pathologies (IMIPP) CONICET-GCBA, Laboratory of Molecular Biology, Pathology Division, Ricardo Gutiérrez Children’s Hospital, CABA C1425, Buenos Aires, Argentina
| | - Pamela Valva
- Multidisciplinary Institute for Investigation in Pediatric Pathologies (IMIPP) CONICET-GCBA, Laboratory of Molecular Biology, Pathology Division, Ricardo Gutiérrez Children’s Hospital, CABA C1425, Buenos Aires, Argentina
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13
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Boglione L, De Benedetto I, Lupia T, Cusato J, Cariti G, Di Perri G. Serological and virological response in patients with hepatitis B virus genotype E treated with entecavir or tenofovir: a prospective study. Arch Virol 2021; 166:1125-1131. [PMID: 33580380 DOI: 10.1007/s00705-021-04992-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/21/2020] [Indexed: 10/22/2022]
Abstract
European clinical practice guidelines (EASL) on chronic hepatitis B (CHB) recently recognized the importance of migration flows in the changing hepatitis B virus (HBV) epidemiology in low-endemic European countries. The role of different genotypes in nucleos(t)ide analogue (NA) treatment is still unknown. In the case of genotype E, which is mainly circulating in West Africa, a quantitative decrease in the level of HBsAg (qHBsAg) during treatment with entecavir (ETV) predicts a longer time to HBsAg loss when compared to genotypes A and D. We prospectively evaluated qHBsAg decline in HBeAg-negative CHB patients infected with HBV genotype E who were treated with tenofovir 245 mg (TDF) or ETV 0.5 mg from 2008 to 2014. Sixty-five West African patients (58; 89.2% males) were enrolled. The median age was 29 years, and the most prevalent route of transmission was familial (25; 38.5%). Median liver stiffness was 7.4 kPa, HBV-DNA was 4.7 Log IU/ml, and qHBsAg was 3.4 Log UI/ml. According to clinical evaluation, 40 patients (61.5%) started ETV treatment, whereas 25 patients (38.5%) started TDF treatment. The decline of qHBsAg in ETV patients was significantly lower than in TDF patients after 5 years of treatment (0.31 vs. 0.68 LogIU/mL, p < 0.001). At the same time points, a significantly higher virological non-response rate was observed in ETV patients (p < 0.001). Despite the partial and non-response rates observed in the ETV group, no mutations associated with drug resistance were detected in these subjects. In genotype E infections, ETV treatment results in a significantly lower decline in qHBsAg and higher rates of virological non-response after 5 years. TDF could represent the optimal choice.
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Affiliation(s)
- Lucio Boglione
- Department of Translational Medicine (DiMET), University of Eastern Piedmont, Via Solaroli 17, 28100, Novara, Italy.
| | - Ilaria De Benedetto
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Tommaso Lupia
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Jessica Cusato
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Giuseppe Cariti
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Giovanni Di Perri
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
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14
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Salpini R, Battisti A, Piermatteo L, Carioti L, Anastasiou OE, Gill US, Di Carlo D, Colagrossi L, Duca L, Bertoli A, La Rosa KY, Fabeni L, Iuvara A, Malagnino V, Cerva C, Lichtner M, Mastroianni CM, De Sanctis GM, Paoloni M, Marignani M, Pasquazzi C, Iapadre N, Parruti G, Vecchiet J, Sarmati L, Andreoni M, Angelico M, Grelli S, T Kennedy P, Verheyen J, Aquaro S, Silberstein FC, Perno CF, Svicher V. Key mutations in the C-terminus of the HBV surface glycoprotein correlate with lower HBsAg levels in vivo, hinder HBsAg secretion in vitro and reduce HBsAg structural stability in the setting of HBeAg-negative chronic HBV genotype-D infection. Emerg Microbes Infect 2020; 9:928-939. [PMID: 32312174 PMCID: PMC7269061 DOI: 10.1080/22221751.2020.1757998] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Increasing evidences suggest that HBsAg-production varies across HBV-genotypes. HBsAg C-terminus plays a crucial role for HBsAg-secretion. Here, we evaluate HBsAg-levels in different HBV-genotypes in HBeAg-negative chronic infection, the correlation of specific mutations in HBsAg C-terminus with HBsAg-levels in-vivo, their impact on HBsAg-secretion in-vitro and on structural stability in-silico. HBsAg-levels were investigated in 323 drug-naïve HBeAg-negative patients chronically infected with HBV genotype-D(N = 228), -A(N = 65) and -E(N = 30). Genotype-D was characterized by HBsAg-levels lower than genotype-A and -E (3.3[2.7–3.8]IU/ml; 3.8[3.5–4.2]IU/ml and 3.9[3.7–4.2]IU/ml, P < 0.001). Results confirmed by multivariable analysis correcting for patients’demographics, HBV-DNA, ALT and infection-status. In genotype-D, specific C-terminus mutations (V190A-S204N-Y206C-Y206F-S210N) significantly correlate with HBsAg<1000IU/ml(P-value from <0.001 to 0.04). These mutations lie in divergent pathways involving other HBsAg C-terminus mutations: V190A + F220L (Phi = 0.41, P = 0.003), S204N + L205P (Phi = 0.36, P = 0.005), Y206F + S210R (Phi = 0.47, P < 0.001) and S210N + F220L (Phi = 0.40, P = 0.006). Notably, patients with these mutational pairs present HBsAg-levels 1log lower than patients without them(P-value from 0.003 to 0.02). In-vitro, the above-mentioned mutational pairs determined a significant decrease in HBsAg secretion-efficiency compared to wt(P-value from <0.001 to 0.02). Structurally, these mutational pairs reduced HBsAg C-terminus stability and determined a rearrangement of this domain. In conclusion, HBsAg-levels in genotype-D are significantly lower than in genotype-A and -E in HBeAg-negative patients. In genotype-D, specific mutational clusters in HBsAg C-terminus correlate with lower HBsAg-levels in-vivo, hamper HBsAg-release in-vitro and affect its structural stability, supporting their detrimental role on HBsAg-secretion. In this light, genotypic-testing can be a valuable tool to optimize the clinical interpretation of HBsAg in genotype-D and to provide information on HBV-pathogenicity and disease-progression.
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Affiliation(s)
- Romina Salpini
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Arianna Battisti
- Barts Liver Centre, Blizard Institute, Barts and The London SMD, QMUL, London, UK
| | - Lorenzo Piermatteo
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Luca Carioti
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Olympia E Anastasiou
- Institute of Virology, University-Hospital, University Duisburg-Essen, Essen, Germany
| | - Upkar S Gill
- Barts Liver Centre, Blizard Institute, Barts and The London SMD, QMUL, London, UK
| | - Domenico Di Carlo
- Paediatric Clinical Research Center "Romeo and Enrica Invernizzi", University of Milan, Milan, Italy
| | - Luna Colagrossi
- Microbiology and Virology Unit, University of Milan, Milan, Italy
| | - Leonardo Duca
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Ada Bertoli
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Katia Yu La Rosa
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Lavinia Fabeni
- Laboratory of Virology, National Institute for Infectious Diseases "Lazzaro Spallanzani" -IRCCS, Rome, Italy
| | - Alessandra Iuvara
- Microbiology and Virology Unit, Tor Vergata University Hospital, Rome, Italy
| | | | - Carlotta Cerva
- Infectious Diseases Unit, Tor Vergata University Hospital, Rome, Italy
| | - Miriam Lichtner
- Public Health and Infectious Disease Department, "Sapienza" University, Rome, Italy
| | | | | | - Maurizio Paoloni
- Infectious Disease Unit, "S.S. Filippo e Nicola" Hospital, Avezzano, Italy
| | | | | | | | - Giustino Parruti
- Infectious Disease Unit, Pescara General Hospital, Pescara, Italy
| | - Jacopo Vecchiet
- Department of Medicine and Science of Aging, Clinic of Infectious Diseases, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Loredana Sarmati
- Infectious Diseases Unit, Tor Vergata University Hospital, Rome, Italy
| | - Massimo Andreoni
- Infectious Diseases Unit, Tor Vergata University Hospital, Rome, Italy
| | - Mario Angelico
- Hepatology Unit, Tor Vergata University Hospital, Rome, Italy
| | - Sandro Grelli
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy.,Microbiology and Virology Unit, Tor Vergata University Hospital, Rome, Italy
| | - Patrick T Kennedy
- Barts Liver Centre, Blizard Institute, Barts and The London SMD, QMUL, London, UK
| | - Jens Verheyen
- Institute of Virology, University-Hospital, University Duisburg-Essen, Essen, Germany
| | - Stefano Aquaro
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy
| | | | | | - Valentina Svicher
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
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15
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Peiffer KH, Spengler C, Basic M, Jiang B, Kuhnhenn L, Obermann W, Zahn T, Glitscher M, Loglio A, Facchetti F, Carra G, Kubesch A, Vermehren J, Knop V, Graf C, Dietz J, Finkelmeier F, Herrmann E, Trebicka J, Grünweller A, Zeuzem S, Sarrazin C, Lampertico P, Hildt E. Quadruple mutation GCAC1809-1812TTCT acts as a biomarker in healthy European HBV carriers. JCI Insight 2020; 5:135833. [PMID: 33055418 PMCID: PMC7710305 DOI: 10.1172/jci.insight.135833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 10/07/2020] [Indexed: 12/14/2022] Open
Abstract
Many mutation analyses of the HBV genome have been performed in the search for new prognostic markers. However, the Kozak sequence preceding precore was covered only infrequently in these analyses. In this study, the HBV core promoter/precore region was sequenced in serum samples from European inactive HBV carriers. Quadruple mutation GCAC1809-1812TTCT was found with a high prevalence of 42% in the Kozak sequence preceding precore among all HBV genotypes. GCAC1809-1812TTCT was strongly associated with coexistence of basal core promoter (BCP) double mutation A1762T/G1764A and lower HBV DNA levels. In vitro GCAC1809-1812TTCT lead to drastically diminished synthesis of pregenomic RNA (pgRNA), precore mRNA, core, HBsAg, and HBeAg. Calculation of the pgRNA secondary structure suggests a destabilization of the pgRNA structure by A1762T/G1764A that was compensated by GCAC1809-1812TTCT. In 125 patients with HBV-related cirrhosis, GCAC1809-1812TTCT was not detected. While a strong association of GCAC1809-1812TTCT with inactive carrier status was observed, BCP double mutation was strongly correlated with cirrhosis, but this was only observed in absence of GCAC1809-1812TTCT. In conclusion, our data reveal that GCAC1809-1812TTCT is highly prevalent in inactive carriers and acts as a compensatory mutation for BCP double mutation. GCAC1809-1812TTCT seems to be a biomarker of good prognosis in HBV infection. HBV core promoter/precore region was sequenced in serum samples of European inactive HBV carriers, revealing that GCAC1809-1812TTCT mutation is highly prevalent in inactive carriers.
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Affiliation(s)
- Kai-Henrik Peiffer
- Department of Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt, Germany.,Paul Ehrlich Institute, Division of Virology, Langen, Germany
| | | | - Michael Basic
- Department of Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt, Germany.,Paul Ehrlich Institute, Division of Virology, Langen, Germany
| | - Bingfu Jiang
- Paul Ehrlich Institute, Division of Virology, Langen, Germany
| | - Lisa Kuhnhenn
- Department of Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt, Germany
| | - Wiebke Obermann
- Institute of Pharmaceutical Chemistry, Philipps-University Marburg, Marburg, Germany
| | - Tobias Zahn
- Paul Ehrlich Institute, Division of Virology, Langen, Germany
| | - Mirco Glitscher
- Paul Ehrlich Institute, Division of Virology, Langen, Germany
| | - Alessandro Loglio
- A.M. and A. Migliavacca Center for Liver Disease, Division of Gastroenterology and Hepatology, Fondazione IRCCS Cà Granda Maggiore Hospital, University of Milan, Milan, Italy
| | - Floriana Facchetti
- A.M. and A. Migliavacca Center for Liver Disease, Division of Gastroenterology and Hepatology, Fondazione IRCCS Cà Granda Maggiore Hospital, University of Milan, Milan, Italy
| | - Gert Carra
- Paul Ehrlich Institute, Division of Virology, Langen, Germany
| | - Alica Kubesch
- Department of Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt, Germany
| | - Johannes Vermehren
- Department of Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt, Germany
| | - Viola Knop
- Department of Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt, Germany
| | - Christiana Graf
- Department of Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt, Germany
| | - Julia Dietz
- Department of Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt, Germany
| | - Fabian Finkelmeier
- Department of Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt, Germany
| | - Eva Herrmann
- Department of Medicine, Institute of Biostatistics and Mathematical Modeling, J.W. Goethe University, Frankfurt, Germany
| | - Jonel Trebicka
- Department of Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt, Germany
| | - Arnold Grünweller
- Institute of Pharmaceutical Chemistry, Philipps-University Marburg, Marburg, Germany
| | - Stefan Zeuzem
- Department of Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt, Germany
| | - Christoph Sarrazin
- Department of Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt, Germany.,Department of Gastroenterology, St. Josefs Hospital, Wiesbaden, Germany
| | - Pietro Lampertico
- A.M. and A. Migliavacca Center for Liver Disease, Division of Gastroenterology and Hepatology, Fondazione IRCCS Cà Granda Maggiore Hospital, University of Milan, Milan, Italy
| | - Eberhard Hildt
- Paul Ehrlich Institute, Division of Virology, Langen, Germany.,German Center for Infection Research (DZIF), Gießen-Marburg-Langen, Germany
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16
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Jiang B, Wen X, Wu Q, Bender D, Carra G, Basic M, Kubesch A, Peiffer KH, Boller K, Hildt E. The N-Terminus Makes the Difference: Impact of Genotype-Specific Disparities in the N-Terminal Part of The Hepatitis B Virus Large Surface Protein on Morphogenesis of Viral and Subviral Particles. Cells 2020; 9:cells9081898. [PMID: 32823751 PMCID: PMC7463600 DOI: 10.3390/cells9081898] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/27/2020] [Accepted: 08/11/2020] [Indexed: 12/12/2022] Open
Abstract
The N-terminus of the hepatitis B virus (HBV) large surface protein (LHB) differs with respect to genotypes. Compared to the amino terminus of genotype (Gt)D, in GtA, GtB and GtC, an additional identical 11 amino acids (aa) are found, while GtE and GtG share another similar 10 aa. Variants of GtB and GtC affecting this N-terminal part are associated with hepatoma formation. Deletion of these amino-terminal 11 aa in GtA reduces the amount of LHBs and changes subcellular accumulation (GtA-like pattern) to a dispersed distribution (GtD-like pattern). Vice versa, the fusion of the GtA-derived N-terminal 11 aa to GtD causes a GtA-like phenotype. However, insertion of the corresponding GtE-derived 10 aa to GtD has no effect. Deletion of these 11aa decreases filament size while neither the number of released viral genomes nor virion size and infectivity are affected. A negative regulatory element (aa 2–8) and a dominant positive regulatory element (aa 9–11) affecting the amount of LHBs were identified. The fusion of this motif to eGFP revealed that the effect on protein amount and subcellular distribution is not restricted to LHBs. These data identify a novel region in the N-terminus of LHBs affecting the amount and subcellular distribution of LHBs and identify release-promoting and -inhibiting aa residues within this motive.
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Affiliation(s)
- Bingfu Jiang
- Division of Virology, Paul-Ehrlich-Institut, D-63225 Langen, Germany; (B.J.); (X.W.); (Q.W.); (D.B.); (G.C.); (M.B.); (A.K.); (K.-H.P.)
| | - Xingjian Wen
- Division of Virology, Paul-Ehrlich-Institut, D-63225 Langen, Germany; (B.J.); (X.W.); (Q.W.); (D.B.); (G.C.); (M.B.); (A.K.); (K.-H.P.)
| | - Qingyan Wu
- Division of Virology, Paul-Ehrlich-Institut, D-63225 Langen, Germany; (B.J.); (X.W.); (Q.W.); (D.B.); (G.C.); (M.B.); (A.K.); (K.-H.P.)
| | - Daniela Bender
- Division of Virology, Paul-Ehrlich-Institut, D-63225 Langen, Germany; (B.J.); (X.W.); (Q.W.); (D.B.); (G.C.); (M.B.); (A.K.); (K.-H.P.)
| | - Gert Carra
- Division of Virology, Paul-Ehrlich-Institut, D-63225 Langen, Germany; (B.J.); (X.W.); (Q.W.); (D.B.); (G.C.); (M.B.); (A.K.); (K.-H.P.)
| | - Michael Basic
- Division of Virology, Paul-Ehrlich-Institut, D-63225 Langen, Germany; (B.J.); (X.W.); (Q.W.); (D.B.); (G.C.); (M.B.); (A.K.); (K.-H.P.)
- Department of Gastroenterology and Hepatology, J. W. Goethe University, D-60590 Frankfurt, Germany
| | - Alica Kubesch
- Division of Virology, Paul-Ehrlich-Institut, D-63225 Langen, Germany; (B.J.); (X.W.); (Q.W.); (D.B.); (G.C.); (M.B.); (A.K.); (K.-H.P.)
- Department of Gastroenterology and Hepatology, J. W. Goethe University, D-60590 Frankfurt, Germany
| | - Kai-Henrik Peiffer
- Division of Virology, Paul-Ehrlich-Institut, D-63225 Langen, Germany; (B.J.); (X.W.); (Q.W.); (D.B.); (G.C.); (M.B.); (A.K.); (K.-H.P.)
- Department of Gastroenterology and Hepatology, J. W. Goethe University, D-60590 Frankfurt, Germany
| | - Klaus Boller
- Department of Immunology, Paul-Ehrlich-Institut, D-63225 Langen, Germany;
| | - Eberhard Hildt
- Division of Virology, Paul-Ehrlich-Institut, D-63225 Langen, Germany; (B.J.); (X.W.); (Q.W.); (D.B.); (G.C.); (M.B.); (A.K.); (K.-H.P.)
- TTU Hepatitis, German Center for Infection Research (DZIF), 38124 Braunschweig, Germany
- Correspondence: ; Tel.: +496103772140
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17
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Cornberg M, Glebe D. Editorial: which factors influence HBsAg levels in HBV-infected patients? Aliment Pharmacol Ther 2020; 52:547-548. [PMID: 32656837 DOI: 10.1111/apt.15864] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Markus Cornberg
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.,Centre for Individualized Infection Medicine (CIIM), Hannover, Germany.,German Center for Infection Research (DZIF), Hannover-Braunschweig, Germany
| | - Dieter Glebe
- Institute of Medical Virology, Justus Liebig University Giessen, National Reference Center for Hepatitis B Viruses and Hepatitis D Viruses, Giessen, Germany.,German Center for Infection Research (DZIF), Giessen-Marburg-Langen, Germany
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18
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Zhai X, Zhu L, Jiang J, Song C, Peng H, Qian J, Zhou M, Zhou Y, Wang Q, Xu J, Wang Z, Liu H, Fan M, Hu Z, Shen H, Zhu F. Virological activity in treatment-naïve HBeAg-negative HBV-infected adult patients: A community-based study in Jiangsu, China. Medicine (Baltimore) 2020; 99:e21179. [PMID: 32702877 PMCID: PMC7373614 DOI: 10.1097/md.0000000000021179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Nowadays most of the hepatitis B virus (HBV) infected population are adults, among which hepatitis B e antigen (HBeAg) negative infection occupied the largest proportion of HBV infection in China. HBeAg-negative patients are heterogeneous, and the corresponding interventions are different. Therefore, it is worth researching the infection characteristics of HBeAg-negative patients to help guide the interventions.A total of 11,738 treatment-naïve HBeAg-negative adult patients were randomly selected, and their demographic and medical history information were collected. The liver biochemistry, and HBV infection biomarkers including hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), HBeAg, hepatitis B e antibody (anti-HBe), hepatitis B core antibody (anti-HBc), and hepatitis B virus deoxyribonucleic acid (HBV-DNA) levels were tested. The infection characteristics and their influencing factors were explored.Sixty percent of the patients presented HBV-DNA-positive, of which 31.2% had HBV-DNA level higher than 2000 IU/mL, and 16.5% had HBV-DNA level higher than 20,000 IU/mL. HBV-DNA levels tended to increase along with the increasing of age, and the male patients had significant higher HBV-DNA levels than the female patients. Twenty-four percent of the patients had abnormal transaminase. The male patients were more vulnerable to abnormal transaminase (30.0%) than the female patients (18.4%). Fifty-five percent patients with HBV-DNA ≥20,000 IU/mL presented abnormal alanine aminotransferase (ALT) or aspartate transaminase (AST), which was significantly higher than that of patients with HBV-DNA levels below 20,000 IU/mL (19.0-21.7%). Multivariate logistic regression analyses revealed that the male patients and the patients with higher viral load had higher risk of having abnormal liver function.A considerable number of HBeAg-negative patients were virological active and had liver damage. It is necessary and urgent to carry out regular active interventions for the chronic HBV-infected patients.
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Affiliation(s)
- Xiangjun Zhai
- Jiangsu Province Center for Disease Prevention and Control, Nanjing
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention
- Key Laboratory of Infectious Diseases, School of Public Health, Nanjing Medical University
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine
| | - Liguo Zhu
- Jiangsu Province Center for Disease Prevention and Control, Nanjing
- Key Laboratory of Infectious Diseases, School of Public Health, Nanjing Medical University
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine
| | - Jie Jiang
- Jiangsu Province Center for Disease Prevention and Control, Nanjing
| | - Ci Song
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing
| | - Hong Peng
- Jiangsu Province Center for Disease Prevention and Control, Nanjing
| | - Jiao Qian
- Jiangsu Province Center for Disease Prevention and Control, Nanjing
| | - MingHao Zhou
- Jiangsu Province Center for Disease Prevention and Control, Nanjing
| | - Yan Zhou
- Zhangjiagang Center for Disease Prevention and Control, Zhangjiagang
| | - Qungang Wang
- Zhangjiagang Center for Disease Prevention and Control, Zhangjiagang
| | - Jianfang Xu
- Danyang Center for Disease Prevention and Control, Danyang
| | - Zhijian Wang
- Danyang Center for Disease Prevention and Control, Danyang
| | - Hongjian Liu
- Taixing Center for Disease Prevention and Control, Taixing, People's Republic of China
| | - Min Fan
- Taixing Center for Disease Prevention and Control, Taixing, People's Republic of China
| | - Zhibin Hu
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing
| | - Hongbin Shen
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing
| | - Fengcai Zhu
- Jiangsu Province Center for Disease Prevention and Control, Nanjing
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention
- Key Laboratory of Infectious Diseases, School of Public Health, Nanjing Medical University
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19
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Cavallone D, Ricco G, Oliveri F, Colombatto P, Moriconi F, Coco B, Romagnoli V, Salvati A, Surace L, Bonino F, Brunetto MR. Do the circulating Pre-S/S quasispecies influence hepatitis B virus surface antigen levels in the HBeAg negative phase of HBV infection? Aliment Pharmacol Ther 2020; 51:1406-1416. [PMID: 32390175 DOI: 10.1111/apt.15753] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 11/19/2019] [Accepted: 04/06/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Virus, host factors and their interplay influence Hepatitis B surface Antigen serum levels during Hepatitis B Virus (HBV) infection course and treatment. AIM To study the Pre-S/S circulating quasispecies in a cohort of untreated, HBeAg negative, genotype-D, HBsAg carriers. METHODS We studied 260 carriers: 71 with HBeAg negative infection (ENI; HBV-DNA ≤2000 IU/mL); 42 Grey Zone (GZ; HBV-DNA ≤20 000 IU/mL); 82 chronic hepatitis (CH) and 65 cirrhosis (CI) (HBV-DNA > 20 000 IU/mL). Population sequencing was applied to identify Pre-S/S gene mutations responsible for any amino acid substitution or potential biological/antigenic implications (M-muts) on HBsAg. RESULTS HBsAg serum levels were lower in ENI + GZ than in CH + CI (2.61 [-1.10/4.06] vs 3.62 [2.41/4.92] log10 IU/mL, P < 0.001) and in CI than CH (3.48 [2.41/4.38] vs 3.66 [2.57/4.92] log10 IU/mL, P < 0.001). M-muts were found in 73 (28.1%) cases: 5 (7.0%) ENI, 3 (7.1%) GZ, 26 (31.7%) CH, 39 (60.0%) CI (P < 0.001) and mostly in Pre-S2 (17.6%) than Pre-S1 (5.8%) and Small-S (10.8%; P < 0.001). Overall HBsAg serum levels were higher in carriers with M-muts (3.56 [0.95/4.38] vs 3.17 [-1.10/4.92] log10 IU/mL, P < 0.001), but comparable in carriers with or without M-mut when considering separately ENI + GZ (2.84 [0.95/3.89] vs 2.61 [-1.10/4.06] log10 IU/mL, P = 0.330] and CH + CI (3.57 [2.67/4.38] vs 3.63 [2.41/4.92] log10 IU/mL, P = 0.37). Infection phase (β: 0.422, P < 0.001), age (β: -0.260, P < 0.001), ALT (β: -0.103, P = 0.045), liver stiffness (β: -0.118, P = 0.039) and HBV-DNA (β: 0.384, P < 0.001), but not M-mut were independently associated with HBsAg serum levels. CONCLUSIONS In HBeAg negative, genotype-D, carriers Pre-S/S heterogeneity increases with severity of liver disease, but does not influence HBsAg serum levels, that in low viraemic carriers are associated with an effective control of HBV.
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Affiliation(s)
- Daniela Cavallone
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,Hepatology Unit and Laboratory of Molecular Genetics and Pathology of Hepatitis Viruses, Pisa University Hospital, Pisa, Italy
| | - Gabriele Ricco
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,Hepatology Unit and Laboratory of Molecular Genetics and Pathology of Hepatitis Viruses, Pisa University Hospital, Pisa, Italy
| | - Filippo Oliveri
- Hepatology Unit and Laboratory of Molecular Genetics and Pathology of Hepatitis Viruses, Pisa University Hospital, Pisa, Italy
| | - Piero Colombatto
- Hepatology Unit and Laboratory of Molecular Genetics and Pathology of Hepatitis Viruses, Pisa University Hospital, Pisa, Italy
| | - Francesco Moriconi
- Hepatology Unit and Laboratory of Molecular Genetics and Pathology of Hepatitis Viruses, Pisa University Hospital, Pisa, Italy
| | - Barbara Coco
- Hepatology Unit and Laboratory of Molecular Genetics and Pathology of Hepatitis Viruses, Pisa University Hospital, Pisa, Italy
| | - Veronica Romagnoli
- Hepatology Unit and Laboratory of Molecular Genetics and Pathology of Hepatitis Viruses, Pisa University Hospital, Pisa, Italy
| | - Antonio Salvati
- Hepatology Unit and Laboratory of Molecular Genetics and Pathology of Hepatitis Viruses, Pisa University Hospital, Pisa, Italy
| | - Lidia Surace
- Hepatology Unit and Laboratory of Molecular Genetics and Pathology of Hepatitis Viruses, Pisa University Hospital, Pisa, Italy
| | - Ferruccio Bonino
- Biostructure and Bio-imaging Institute of National Research Council of Italy, Naples, Italy
| | - Maurizia Rossana Brunetto
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,Hepatology Unit and Laboratory of Molecular Genetics and Pathology of Hepatitis Viruses, Pisa University Hospital, Pisa, Italy.,Biostructure and Bio-imaging Institute of National Research Council of Italy, Naples, Italy
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20
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Cornberg M, Lok ASF, Terrault NA, Zoulim F. Guidance for design and endpoints of clinical trials in chronic hepatitis B - Report from the 2019 EASL-AASLD HBV Treatment Endpoints Conference ‡. J Hepatol 2020; 72:539-557. [PMID: 31730789 DOI: 10.1016/j.jhep.2019.11.003] [Citation(s) in RCA: 179] [Impact Index Per Article: 44.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 10/07/2019] [Accepted: 11/03/2019] [Indexed: 12/11/2022]
Abstract
Representatives from academia, industry, regulatory agencies, and patient groups convened in March 2019 with the primary goal of developing agreement on chronic HBV treatment endpoints to guide clinical trials aiming to 'cure' HBV. Agreement among the conference participants was reached on some key points. 'Functional' but not sterilising cure is achievable and should be defined as sustained HBsAg loss in addition to undetectable HBV DNA 6 months post-treatment. The primary endpoint of phase III trials should be functional cure; HBsAg loss in ≥30% of patients was suggested as an acceptable rate of response in these trials. Sustained virologic suppression (undetectable serum HBV DNA) without HBsAg loss 6 months after discontinuation of treatment would be an intermediate goal. Demonstrated validity for the prediction of sustained HBsAg loss was considered the most appropriate criterion for the approval of new HBV assays to determine efficacy endpoints. Clinical trials aimed at HBV functional cure should initially focus on patients with HBeAg-positive or negative chronic hepatitis, who are treatment-naïve or virally suppressed on nucleos(t)ide analogues. A hepatitis flare associated with an increase in bilirubin or international normalised ratio should prompt temporary or permanent cessation of an investigational treatment. New treatments must be as safe as existing nucleos(t)ide analogues. The primary endpoint for phase III trials for HDV coinfection should be undetectable serum HDV RNA 6 months after stopping treatment. On treatment HDV RNA suppression associated with normalisation of alanine aminotransferase is considered an intermediate goal. In conclusion, regarding HBV 'functional cure', the primary goal is sustained HBsAg loss with undetectable HBV DNA after completion of treatment and the intermediate goal is sustained undetectable HBV DNA without HBsAg loss after stopping treatment.
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Affiliation(s)
- Markus Cornberg
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany; German Centre for Infection Research (DZIF), partner site Hannover-Braunschweig, Germany; Centre for Individualised Infection Medicine (CiiM), Hannover, Germany.
| | - Anna Suk-Fong Lok
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA
| | - Norah A Terrault
- Division of Gastrointestinal and Liver Diseases, Keck Medicine at University of Southern California, Los Angeles, CA, USA
| | - Fabien Zoulim
- Hepatology Department, Hospices Civils de Lyon, INSERM U1052, University of Lyon, France
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21
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Cornberg M, Lok ASF, Terrault NA, Zoulim F. Guidance for design and endpoints of clinical trials in chronic hepatitis B - Report from the 2019 EASL-AASLD HBV Treatment Endpoints Conference. Hepatology 2019; 71:1070-1092. [PMID: 31713892 DOI: 10.1002/hep.31030] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Representatives from academia, industry, regulatory agencies, and patient groups convened in March 2019 with the primary goal of developing agreement on chronic hepatitis B virus (HBV) treatment endpoints to guide clinical trials aiming to 'cure' HBV. Agreement among the conference participants was reached on some key points. 'Functional' but not sterilizing cure is achievable and should be defined as sustained HBsAg loss in addition to undetectable HBV DNA 6 months post-treatment. The primary endpoint of phase 3 trials should be functional cure; HBsAg loss in ≥30% of patients was suggested as an acceptable rate of response in these trials. Sustained virologic suppression (undetectable serum HBV DNA) without HBsAg loss, 6 months after discontinuation of treatment would be an intermediate goal. Demonstrated validity in predicting sustained HBsAg loss was considered the most appropriate criterion for the approval of new HBV assays to determine efficacy endpoints. Clinical trials aimed at HBV functional cure should initially focus on patients with HBeAg-positive and HBeAg-negative chronic hepatitis, treatment-naïve or virally suppressed on nucleos(t)ide analogues. A hepatitis flare associated with increase in bilirubin or INR should prompt temporary or permanent cessation of investigational treatment. New treatments must be as safe as existing nucleos(t)ide analogues. The primary endpoint for phase 3 trials for hepatitis D virus (HDV) co-infection should be undetectable serum HDV RNA 6 months after stopping treatment. On treatment HDV RNA suppression associated with normalization of ALT is considered an intermediate goal. CONCLUSION: For HBV 'functional cure', sustained HBsAg loss with undetectable HBV DNA after completion of treatment is the primary goal and sustained undetectable HBV DNA without HBsAg loss after stopping treatment an intermediate goal.
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Affiliation(s)
- Markus Cornberg
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
- German Centre for Infection Research (DZIF), partner site Hannover-Braunschweig, Germany
- Centre for Individualised Infection Medicine (CiiM), Hannover, Germany
| | - Anna Suk-Fong Lok
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA
| | - Norah A Terrault
- Division of Gastrointestinal and Liver Diseases, Keck Medicine at University of Southern California, Los Angeles, CA, USA
| | - Fabien Zoulim
- Hepatology Department, Hospices Civils de Lyon, INSERM U1052, University of Lyon, France
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22
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Gil-García AI, Madejón A, Francisco-Recuero I, López-López A, Villafranca E, Romero M, García A, Olveira A, Mena R, Larrubia JR, García-Samaniego J. Prevalence of hepatocarcinoma-related hepatitis B virus mutants in patients in grey zone of treatment. World J Gastroenterol 2019; 25:5883-5896. [PMID: 31636479 PMCID: PMC6801187 DOI: 10.3748/wjg.v25.i38.5883] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 08/08/2019] [Accepted: 09/13/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Antiviral treatment of patients with chronic hepatitis B (CHB) in the grey zone of treatment comands risk management in order to optimize the health outcome. In this sense, the identification of HBV mutants related with an increased risk of hepatocellular carcinoma (HCC) could be useful to identify subpopulations with potential indication of antiviral treatment.
AIM To analyze the prevalence/persistence of hepatitis B virus (HBV) preS and basal core promoter (BCP)/precore/core variants associated to HCC development in CHB patients in the grey zone.
METHODS Work was designed as a longitudinal retrospective study, including 106 plasma samples from 31 patients with CHB in the grey zone of treatment: Hepatitis B e antigen negative, HBV-DNA levels between 12-20000 IU/mL, normal or discordant transaminase levels during follow up and mild/moderate necro-inflammatory activity in liver biopsy or Fibroscan (up to 9.5 kPa). Serum HBV-DNA was tested using the Abbott Real Time HBV Assay and the BCP/precore/core and the hepatitis B surface antigen (HBsAg) coding regions were analyzed in positive samples by PCR/bulk-sequencing to identify the HCC-related HBV mutants.
RESULTS High-risk HCC related mutants were detected in 24 (77%) patients: 19 (61%) in the BCP/precore/core, and 7 (23%) in the HBsAg coding region (2 preS1 and 5 preS2 deletions). The prevalence of preS deletions was genotype-dependent: 3/5 (60%) patients with preS2 deletions and 1/2 with preS1 deletions were infected with the HBV-E genotype. Since HBV-E was the most prevalent in sub-Saharan patients, a correlation between preS deletions and ethnicity was also found: 6/8 (75%) sub-Saharan vs 1/19 (5%) Caucasian patients had preS deletions (P = 0.00016). Remarkably, this correlation was maintained in those patients infected with HBV-A, a minor genotype in sub-Saharan patients: 2/2 patients infected with HBV-A from West Africa vs 0/6 of Caucasian origin had preS deletions. The HCC related variants were the major strains and persisted over time (up to 48 mo). Patients with preS deletions had a significant higher prevalence of F2 fibrosis stage than the negatives (57% vs 10%, P = 0.0078).
CONCLUSION HBV genetic analysis of selected populations, like sub-Saharans infected with HBV-E/A genotypes, will allow identification of subpopulations with risk of HCC development due to accumulation of high-risk HBV variants, thus commanding their increased clinical surveillance.
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Affiliation(s)
- Ana Isabel Gil-García
- Hepatology Unit, Hospital Universitario La Paz, Madrid 28046, Spain
- Centro de Investigación Biomédica en Red, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Antonio Madejón
- Hepatology Unit, Hospital Universitario La Paz, Madrid 28046, Spain
- Centro de Investigación Biomédica en Red, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Irene Francisco-Recuero
- Hepatology Unit, Hospital Universitario La Paz, Madrid 28046, Spain
- Centro de Investigación Biomédica en Red, Instituto de Salud Carlos III, Madrid 28029, Spain
- Instituto de Investigación del Hospital Universitario la Paz, Madrid 28046, Spain
| | - Ana López-López
- Biochemistry Department, Faculty of Medicine, Universidad Autónoma de Madrid, Madrid 28029, Spain
| | | | - Miriam Romero
- Hepatology Unit, Hospital Universitario La Paz, Madrid 28046, Spain
- Centro de Investigación Biomédica en Red, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Araceli García
- Hepatology Unit, Hospital Universitario La Paz, Madrid 28046, Spain
| | - Antonio Olveira
- Hepatology Unit, Hospital Universitario La Paz, Madrid 28046, Spain
- Centro de Investigación Biomédica en Red, Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Rocío Mena
- Instituto de Genética Médica y Molecular, Hospital Universitario La Paz, Madrid 28046, Spain
| | - Juan Ramón Larrubia
- Translational Hepatology Unit, Hospital General Universitario de Guadalajara, Guadalajara 19002, Castilla-La Mancha, Spain
| | - Javier García-Samaniego
- Hepatology Unit, Hospital Universitario La Paz, Madrid 28046, Spain
- Centro de Investigación Biomédica en Red, Instituto de Salud Carlos III, Madrid 28029, Spain
- Instituto de Investigación del Hospital Universitario la Paz, Madrid 28046, Spain
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23
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Jiang B, Wu Q, Kuhnhenn L, Akhras S, Spengler C, Boller K, Peiffer KH, Hildt E. Formation of semi-enveloped particles as a unique feature of a hepatitis B virus PreS1 deletion mutant. Aliment Pharmacol Ther 2019; 50:940-954. [PMID: 31240738 DOI: 10.1111/apt.15381] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 04/29/2019] [Accepted: 05/29/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Naturally occurring variants with deletions or mutations in the C-terminal PreS1 domain from hepatitis B virus (HBV) chronically infected patients have been shown to promote HBsAg retention, inhibit HBsAg secretion and change the extracellular appearance of PreS1-containing HBV particles (filaments and virions). AIMS To study the impact of N-terminal deletion in preS1 domain on viral secretion and morphogenesis. METHODS An HBV mutant with 15 amino acids (aa 25-39) deletion in N-terminal preS1 was isolated. Intracellular and extracellular HBsAg were quantified by Western blot. Subcellular HBsAg distribution was analysed by confocal laser scanning microscopy. The viral morphology was characterised by sucrose density gradient ultracentrifugation, Western blot, electron microscopy, HBV mixed ELISA and HBV particle gel essay. RESULTS Expression of this mutant genome released higher amounts of HBsAg in the form of shorter filaments. A significant fraction of semi-enveloped virions was observed in the supernatant that has been unprecedented so far. Stepwise insertion of aa 25-31, aa 32-39 and aa 25-39 increased the length of filaments. The rescue of aa 25-31 and aa 25-39 drastically reduced the amounts of extracellular HBsAg and semi-enveloped virions, while such effects could not be observed after insertion of aa 32-39, arguing against a simple spacer function of this region. The deletion and rescued mutants do not differ in subcellular HBsAg distribution and colocalisation with ER, Golgi and multivesicular bodies markers arguing against differences in release pathways. CONCLUSION N-terminal PreS1-domain (aa 25-31) determines HBsAg secretion and triggers proper assembly of PreS1-containing particles.
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Affiliation(s)
- Bingfu Jiang
- Division of Virology, Paul-Ehrlich-Institut, Langen, Germany
| | - Qingyan Wu
- Division of Virology, Paul-Ehrlich-Institut, Langen, Germany
| | - Lisa Kuhnhenn
- Division of Virology, Paul-Ehrlich-Institut, Langen, Germany.,Department of Gastroenterology and Hepatology, J. W. Goethe University, Frankfurt, Germany
| | - Sami Akhras
- Division of Virology, Paul-Ehrlich-Institut, Langen, Germany
| | | | - Klaus Boller
- Department of Immunology, Paul-Ehrlich-Institut, Langen, Germany
| | - Kai-Henrik Peiffer
- Division of Virology, Paul-Ehrlich-Institut, Langen, Germany.,Department of Gastroenterology and Hepatology, J. W. Goethe University, Frankfurt, Germany
| | - Eberhard Hildt
- Division of Virology, Paul-Ehrlich-Institut, Langen, Germany.,German Center for Infection Research (DZIF), Germany
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24
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Higher rates of HBsAg clearance with tenofovir-containing therapy in HBV/HIV co-infection. PLoS One 2019; 14:e0215464. [PMID: 30998789 PMCID: PMC6472771 DOI: 10.1371/journal.pone.0215464] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 03/29/2019] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Achieving functional cure of chronic HBV infection (Hepatitis B surface antigen [HBsAg] clearance, eventually followed by acquisition of anti-hepatitis B surface antigen [Anti-HBs]) in individuals with HIV and HBV infections is a rare event. In this setting, factors related to HBV cure have not yet been fully characterized. METHODS HIV-infected individuals with chronic HBV infection enrolled in the French Dat'AIDS cohort (NCT02898987), who started combined antiretroviral (cART)-anti-HBV treatment were retrospectively analyzed for HBsAg loss and Anti-HBs seroconversion. RESULTS Overall, 1419 naïve-subjects received three different cART-anti-HBV treatment schedule: (1) 3TC or FTC only (n = 150), (2) TDF with or without 3TC or FTC (n = 489) and (3) 3TC or FTC as first line followed by adding/switching to TDF as second line (n = 780). Individuals were followed-up for a median of 89 months (IQR, 56-118). HBV-DNA was < 15 IU/mL in 91% of individuals at the end of the follow-up. Overall, 97 individuals cleared HBsAg (0.7/100 patient-years), of whom, 67 seroconverted for Anti-HBs (0.5/100 patient-years). A high CD4 nadir, a short delay between HBV diagnosis and treatment, a longer time on HBV therapy, an African origin and TDF-based therapy were independent predictors of HBsAg clearance (Probability of odds ratio [OR]>1, >95%) suggested by Bayesian analysis. Also, TDF-based regimen as first line (OR, 3.03) or second line (OR, 2.95) increased rates of HBsAg clearance compared to 3TC or FTC alone, with a 99% probability. CONCLUSIONS HBsAg clearance rate was low in HIV-HBV co-infected cART-anti-HBV treated individuals, but was slightly improved on TDF-based regimen.
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25
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Wang T, Cui D, Chen S, Xu X, Sun C, Dai Y, Cheng J. Analysis of clinical characteristics and S gene sequences in chronic asymptomatic HBV carriers with low-level HBsAg. Clin Res Hepatol Gastroenterol 2019; 43:179-189. [PMID: 30293895 DOI: 10.1016/j.clinre.2018.08.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 08/20/2018] [Accepted: 08/22/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND During the natural hepatitis B virus (HBV) infection process, some infected subjects are characterized by a sustained low serum HBV surface antigen (HBsAg) expression level. Most members in this population are chronic asymptomatic HBV carriers (ASCs). To elucidate the mechanism underlying low-level HBsAg expression in ASCs, we sequenced the HBV S gene in these patients to reveal specific sequence characteristics. METHODS Overall, 1308 cases of chronic ASCs were grouped according to their HBsAg serum expression levels (10 IU/mL). The clinical characteristics of the population were analysed in detail. The HBV S gene was sequenced from 276 ASC cases with low-level HBsAg expression. Additionally, 100 of 1032 ASC cases with high-level HBsAg expression were randomly selected for HBV S gene sequencing based on age matching according to the low-level HBsAg group. A comparative analysis was conducted with the HBV S gene sequences from ASCs with low HBsAg expression and the HBV reference S gene sequences from ASCs with high HBsAg expression. RESULTS The population with low-level HBsAg expression displayed the following primary clinical characteristics: mostly chronic asymptomatic HBV carriers, older age (mean age 55.09 years), HBsAg/anti-HBe/anti-HBc (core) positivity as the main serological pattern (97.1%), low HBV DNA replication (1.32 ± 1.60 log10 IU/mL), a low HBV-DNA positive rate (45.65%) and primarily genotype B (82.54%) and serotype adw (84.13%). The comparative analysis of the HBV S gene sequences from ASCs with low-level HBsAg showed significant mutations (including co-mutations) on both sides of the main hydrophilic region (MHR). CONCLUSION Significant mutations in multiple regions and at multiple sites (including co-mutations) on both sides of the MHR may be one cause of the low HBsAg expression level in this population.
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Affiliation(s)
- Tong Wang
- Faculty of Graduate Studies, Bengbu Medical College, Bengbu 233000, PR China; Department of Clinical Research, The 117th Hospital of PLA, Hangzhou 310013, PR China; Faculty of Graduate Studies, Jiangsu University, Zhenjiang 212013, PR China.
| | - Dawei Cui
- Department of Laboratory Medicine, Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, PR China; Faculty of Graduate Studies, Jiangsu University, Zhenjiang 212013, PR China.
| | - Shaoming Chen
- Department of Clinical Research, The 117th Hospital of PLA, Hangzhou 310013, PR China; Faculty of Graduate Studies, Jiangsu University, Zhenjiang 212013, PR China.
| | - Xujian Xu
- Department of Biotechnology, The University of Tokyo, Tokyo 1138656, Japan; Faculty of Graduate Studies, Jiangsu University, Zhenjiang 212013, PR China.
| | - Changgui Sun
- Department of Clinical Research, The 117th Hospital of PLA, Hangzhou 310013, PR China; Faculty of Graduate Studies, Jiangsu University, Zhenjiang 212013, PR China.
| | - Yuzhu Dai
- Department of Clinical Research, The 117th Hospital of PLA, Hangzhou 310013, PR China; Department of Laboratory Medicine, Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, PR China.
| | - Jun Cheng
- Department of Clinical Research, The 117th Hospital of PLA, Hangzhou 310013, PR China; Faculty of Graduate Studies, Jiangsu University, Zhenjiang 212013, PR China.
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26
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Chen EQ, Wang ML, Wu DB, Liao J, Tang H. Letter: impact of HBV genotypes and PC/BCP mutations on serum HBsAg levels in Chinese HBeAg-negative patients. Aliment Pharmacol Ther 2018; 48:236-237. [PMID: 29939408 DOI: 10.1111/apt.14815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- E-Q Chen
- Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China
| | - M-L Wang
- Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China
| | - D-B Wu
- Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China
| | - J Liao
- Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China
| | - H Tang
- Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China
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27
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Alexopoulou A, Karayiannis P. Editorial: HBsAg serum levels in HBeAg-negative chronic HBV infection-is it a matter of genotype? Aliment Pharmacol Ther 2018; 48:102-103. [PMID: 29882982 DOI: 10.1111/apt.14681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- A Alexopoulou
- 2nd Department of Medicine, Medical School, National & Kapodisrian University of Athens, Hippokration General Hospital, Athens, Greece
| | - P Karayiannis
- University of Nicosia Medical School, Engomi, Nicosia, Cyprus
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28
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Kuhnhenn L, Jiang B, Kubesch A, Zeuzem S, Sarrazin C, Hildt E, Peffer KH. Letter: impact of HBV genotypes and PC/BCP mutations on serum HBsAg levels in Chinese HBeAg negative patients-Authors' reply. Aliment Pharmacol Ther 2018; 48:238-239. [PMID: 29939412 DOI: 10.1111/apt.14836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- L Kuhnhenn
- Department of Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt, Germany.,Division of Virology, Paul Ehrlich Institute, Langen, Germany
| | - B Jiang
- Division of Virology, Paul Ehrlich Institute, Langen, Germany
| | - A Kubesch
- Department of Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt, Germany
| | - S Zeuzem
- Department of Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt, Germany
| | - C Sarrazin
- Department of Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt, Germany.,Department of Gastroenterology, St. Josefs Hospital, Wiesbaden, Germany
| | - E Hildt
- Division of Virology, Paul Ehrlich Institute, Langen, Germany.,German Center for Infection Research (DZIF), Langen, Germany
| | - K-H Peffer
- Department of Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt, Germany.,Division of Virology, Paul Ehrlich Institute, Langen, Germany
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29
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Kuhnhenn L, Jiang B, Kubesch A, Zeuzem S, Sarrazin C, Hildt E, Peiffer KH. Editorial: HBsAg serum levels in HBeAg-negative chronic HBV infection-is it a matter of genotype? Authors' reply. Aliment Pharmacol Ther 2018; 48:103-104. [PMID: 29882986 DOI: 10.1111/apt.14793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Affiliation(s)
- L Kuhnhenn
- Department of Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt, Germany.,Division of Virology, Paul Ehrlich Institute, Langen, Germany
| | - B Jiang
- Division of Virology, Paul Ehrlich Institute, Langen, Germany
| | - A Kubesch
- Department of Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt, Germany
| | - S Zeuzem
- Department of Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt, Germany
| | - C Sarrazin
- Department of Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt, Germany.,Department of Gastroenterology, St. Josefs Hospital, Wiesbaden, Germany
| | - E Hildt
- Division of Virology, Paul Ehrlich Institute, Langen, Germany.,German Center for Infection Research (DZIF), Gießen-Marburg-Langen, Germany
| | - K-H Peiffer
- Department of Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt, Germany.,Division of Virology, Paul Ehrlich Institute, Langen, Germany
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