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Gerhards C, Teufel A, Gerigk M, French M, Antoni C, Ebert M, Neumaier M, Evliyaoglu O. Potential role of Vitamin D in immune response in patients with viral hepatitis. Nutrition 2024; 124:112447. [PMID: 38669827 DOI: 10.1016/j.nut.2024.112447] [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: 12/15/2023] [Revised: 03/28/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND To study the relationship of Vitamin D with innate and adaptive immune response parameters in chronic hepatitis B and C patients. METHODS The laboratory data between January 1, 2013 and February 1, 2023, for patients with chronic hepatitis B (CHB), and chronic hepatitis C (CHC) were extracted. Serum 25-hydroxyl vitamin D, hepatitis B virus serological markers, complements, and subsets of T lymphocytes were determined. Study cohorts were divided into groups based on serum 25-hydroxyl vitamin D levels with further evaluation of laboratory data. RESULTS In CHB and CHC patients the percentage of CD4+ T lymphocytes and the CD4+/CD8+ ratio significantly decreased (P < 0.05), but the percentage of CD8+ increased (P < 0.05) compared to the control group. In CHB patients Vitamin D decrease was significant (P < 0.001) but not in CHC patients. Vitamin D showed a moderate negative influence on the CD8 cell count in CHB patients. The positive ratio of HBV DNA and HBsAg decreased with increasing serum vitamin D levels. The vitamin D deficient group showed significantly lower antibody production compared to the normal group, and exhibited significantly decreased CD4 numbers and increased CD8 numbers (P < 0.05 and P < 0.001, respectively), while the CD4/CD8 ratio was also significantly decreased in the insufficiency group (P < 0.001). Complement C3 levels were not associated with CD4 and CD8, but had an inverse relation with Vitamin D. Vitamin D levels were significantly associated with complement C3, CD8+, CD4+, CD19+ cells, and HBV DNA levels. CONCLUSIONS Vitamin D may be a modulator of immune function not only via CD8+ and CD4+ cells but also via CD19+ cells in the course of chronic HBV infection. The negative relationship between vitamin D and complement C3 needs elucidation. Moreover, the increased proportion of B cells and decreased CD4+ cells in Vitamin D deficiency disrupt the immune response against HBV since the expected antibody response was not obtained despite the increase in B cell ratio. This indicates an influence of CD4+ cells for B cell functionality. In summary, sufficient levels of Vitamin D may lead to a sustained virological response that is debatable by artificially correcting the deficiency.
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Affiliation(s)
- Catharina Gerhards
- Institute for Clinical Chemistry, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Andreas Teufel
- Division of Hepatology, Division of Clinical Bioinformatics, Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Marlis Gerigk
- Institute of Medical Microbiology and Hygiene, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - Michael French
- Institute for Clinical Chemistry, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Christoph Antoni
- Clinical Cooperation Unit Healthy Metabolism, Center for Disease Prevention and Digital Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Matthias Ebert
- Clinical Cooperation Unit Healthy Metabolism, Center for Disease Prevention and Digital Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Medicine II, University, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Michael Neumaier
- Institute for Clinical Chemistry, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Osman Evliyaoglu
- Institute for Clinical Chemistry, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany.
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Charatcharoenwitthaya P, Kaewdech A, Piratvisuth T. Controversies in Treating Chronic HBV: The Role of PEG-interferon-alfa. Clin Liver Dis 2021; 25:741-762. [PMID: 34593151 DOI: 10.1016/j.cld.2021.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Pegylated interferon-alpha therapy is one of the first-line chronic hepatitis B treatment. Finite treatment duration, absence of drug resistance, delayed response, and higher hepatitis B surface antigen loss than nucleos(t)ides analog therapy are the advantages of pegylated interferon-alpha treatment. Common side effects and subcutaneous injections requirement limit its use. Identifying patients likely to respond to pegylated interferon-alpha and optimizing treatment is reasonable. Motivating patients to complete the 48-week treatment is necessary. Treatment is stopped or switched to other treatment strategies in patients with stopping rule criteria. Combination therapy with nucleos(t)ides analog may improve response, but remains controversial.
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Affiliation(s)
- Phunchai Charatcharoenwitthaya
- Gastroenterology Division, Department of Internal Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Wang-Lang Road, Bangkok 10700, Thailand
| | - Apichat Kaewdech
- Gastroenterology and Hepatology Unit, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Kanchanawanich Road, Songkhla 90110, Thailand
| | - Teerha Piratvisuth
- Gastroenterology and Hepatology Unit, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Kanchanawanich Road, Songkhla 90110, Thailand; NKC Institute of Gastroenterology and Hepatology, Songklanagarind Hospital, Prince of Songkla University, Kanchanawanich Road, Songkhla 90110, Thailand.
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Gotlieb N, Tachlytski I, Lapidot Y, Sultan M, Safran M, Ben-Ari Z. Hepatitis B virus downregulates vitamin D receptor levels in hepatoma cell lines, thereby preventing vitamin D-dependent inhibition of viral transcription and production. Mol Med 2018; 24:53. [PMID: 30326825 PMCID: PMC6192355 DOI: 10.1186/s10020-018-0055-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 09/28/2018] [Indexed: 02/06/2023] Open
Abstract
Background Vitamin D is a key immune-modulator that plays a role in the innate and adaptive immune systems. Certain pathogens impair the immune defense by downregulating the vitamin D receptor (VDR) pathway. Low serum levels of vitamin D are associated with increased hepatitis B virus (HBV) replication. Our study aimed to assess the in-vitro relationship between HBV production and Vitamin D signaling pathway and to explore the associated mechanism(s). Methods HBV transcription and replication was evaluated by qRT-PCR of the HBV-RNA and covalently closed circular DNA (cccDNA). Furthermore, we have transfected the 1.3 X HBV-Luc plasmid to the cells and measured the Luciferase activity using Luminometer. Vitamin D signaling pathway activation was evaluated by measuring the expression levels of VDR, CYP24A1, Tumor necrosis factor α (TNFα) and cathelicidin (CAMP) by qRT-PCR. All assays were performed on HepG2.2.15, HepG2, and HepAD38 cells treated with or without Vitamin D active metabolite: calcitriol. Results Calcitriol did not suppress HBV transcription, cccDNA expression or HBV RNA levels in HepG2.2.15 cells. However, VDR transcript levels in HepG2.215 cells were significantly lower compared to HepG2 cells. Similar results were obtained in HepAD38 cell where VDR expression was down-regulated when HBV transcript level was up-regulated. In addition, calcitriol induced VDR-associated signaling, resulting in upregulation of CYP24A1, TNFα and CAMP expression level in HepG2 cells but not in the HepG2.2.15 cells. Conclusions These findings indicate that VDR expression is downregulated in HBV-transfected cells, thereby preventing vitamin D from inhibiting transcription and translation of HBV in vitro. HBV might use this mechanism to avoid the immunological defense system by affecting both TNFα and CAMP signaling pathways. Electronic supplementary material The online version of this article (10.1186/s10020-018-0055-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Neta Gotlieb
- Liver Reaserch Laboratory, Sheba Medical Center, Tel Hashomer, 52620, Ramat Gan, Israel
| | - Irena Tachlytski
- Liver Reaserch Laboratory, Sheba Medical Center, Tel Hashomer, 52620, Ramat Gan, Israel
| | - Yelena Lapidot
- Liver Reaserch Laboratory, Sheba Medical Center, Tel Hashomer, 52620, Ramat Gan, Israel.,The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Maya Sultan
- Liver Reaserch Laboratory, Sheba Medical Center, Tel Hashomer, 52620, Ramat Gan, Israel
| | - Michal Safran
- Liver Reaserch Laboratory, Sheba Medical Center, Tel Hashomer, 52620, Ramat Gan, Israel
| | - Ziv Ben-Ari
- Liver Reaserch Laboratory, Sheba Medical Center, Tel Hashomer, 52620, Ramat Gan, Israel. .,Liver Disease Center, Sheba Medical Center, Tel Hashomer, 52620, Ramat Gan, Israel. .,The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Wang T, Dai Y, Zhang M, Cui D, Xu X, Sun C, Cheng J. Sequence analysis of the Pre-S gene in chronic asymptomatic HBV carriers with low-level HBsAg. Int J Mol Med 2018; 42:2689-2699. [PMID: 30132518 PMCID: PMC6192773 DOI: 10.3892/ijmm.2018.3831] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 08/14/2018] [Indexed: 12/13/2022] Open
Abstract
In a hepatitis B virus (HBV)-infected population, persistently low expression levels of serum HBV serum antigen (HBsAg) are present, particularly in chronic asymptomatic HBV carriers (ASCs). The present study sequenced the HBV Pre-S gene, and aimed to elucidate its features in ASCs with low HBsAg expression compared with in the established HBV Pre-S reference gene sequences from ASCs with high HBsAg expression. A total of 1,308 ASCs were grouped according to HBsAg serum levels (cut-off value, 10 IU/ml), and clinical characteristics were analyzed in detail. The HBV Pre-S gene was sequenced in 276 ASCs with low-level HBsAg; in addition, 100 of the remaining 1,032 ASCs with high-level HBsAg were randomly selected for HBV Pre-S gene sequencing on the basis of age matching with the low-level HBsAg group. Comparative analysis of the gene sequences from these groups was subsequently conducted. The major clinical features of the population with low-level HBsAg were as follows: Most were ASCs with chronic HBV infection; 97.1% were HBsAg/anti-HBe/anti-HBc-positive; 82.54% carried the B genotype; and 84.13% displayed the adw serotype. The results indicated that there were novel and meaningful mutations, including co-mutations, at numerous loci and sites in the Pre-S gene, as well as deletion mutations in the Pre-S2 gene. These mutations in the Pre-S1 and Pre-S2 gene frag ments accounted for 65.38% (68/104) of the 104 B genotype cases in the low-level HBsAg group and 90.91% (20/22) of the 22 C genotype cases in the low-level HBsAg group, respectively. In conclusion, Pre-S gene mutations may be associated with HBV replication defects, which may be the cause of the observed low expression levels of HBsAg.
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Affiliation(s)
- Tong Wang
- Faculty of Graduate Studies, Bengbu Medical College, Bengbu, Anhui 233000, P.R. China
| | - Yuzhu Dai
- Department of Clinical Laboratory, The 117th Hospital of PLA, Hangzhou, Zhejiang 310013, P.R. China
| | - Meng Zhang
- Department of Clinical Laboratory, The 117th Hospital of PLA, Hangzhou, Zhejiang 310013, P.R. 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, Zhejiang 310003, P.R. China
| | - Xujian Xu
- Department of Biotechnology, The University of Tokyo, Tokyo 1138656, Japan
| | - Changgui Sun
- Department of Clinical Laboratory, The 117th Hospital of PLA, Hangzhou, Zhejiang 310013, P.R. China
| | - Jun Cheng
- Department of Clinical Laboratory, The 117th Hospital of PLA, Hangzhou, Zhejiang 310013, P.R. China
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Zhu MY, Chen PZ, Li J, Yu DM, Huang D, Zhu XJ, Han Y, Chen J, Huang W, Chen YY, Gong QM, Jiang JH, Zhang DH, Zhang Y, Zhang JM, Zhang XX. Serum M2BPGi level is a novel predictive biomarker for the responses to pegylated interferon-α treatment in HBeAg-positive chronic hepatitis B patients. J Med Virol 2018; 90:721-729. [PMID: 29247529 PMCID: PMC5838532 DOI: 10.1002/jmv.25010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 11/20/2017] [Indexed: 12/23/2022]
Abstract
Serum Mac‐2‐binding protein glycosylation isomer (M2BPGi) level was found to be a useful prognostic marker for hepatitis B e antigen (HBeAg)‐positive chronic hepatitis B (CHB) patients treated with nucleoside/nucleotide analogs (NUCs) therapy, and the aim of our study is to evaluate the clinical implementation of M2BPGi level in the prediction of antiviral responses to pegylated‐interferon‐α (PEG‐IFN‐α) treatment in HBeAg‐positive CHB patients. Ninety‐six CHB patients who received PEG‐IFN‐α treatment for at least 48 weeks were recruited. The serum M2BPGi, alanine aminotransferase (ALT), hepatitis B surface antigen (HBsAg), HBeAg, and HBV DNA levels at baseline, weeks 4, 12, and 24 after PEG‐IFN‐α treatment were determined and their associations with antiviral responses were evaluated and the virological response (VR) rate and serological response (SR) rate after 48 weeks of treatment were 65.6% and 35.4%, respectively. Baseline serum M2BPGi level was significantly different between VR and non‐VR (P = 0.002) or SR and non‐SR groups (P = 0.012). Multivariate analyses suggested that baseline serum M2BPGi level was independently associated with VR and SR of PEG‐IFN‐α treatment at week 48. The area under the ROC curve (AUC) of baseline M2BPGi was 0.682 in predicting VR, which was superior to HBsAg (AUC = 0.566) or HBV DNA (AUC = 0.567). The AUC of baseline M2BPGi in predicting SR was 0.655, which was also higher than that of HBsAg (AUC = 0.548) or HBV DNA (AUC = 0.583). These results suggested that baseline serum M2BPGi level was a novel predictor of VR and SR for PEG‐IFN‐α treatment in HBeAg‐positive CHB patients.
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Affiliation(s)
- Ming-Yu Zhu
- Clinical Virology Research Laboratory, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Pei-Zhan Chen
- Translational Medicine Research Center, Ruijin Hospital North, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jing Li
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - De-Min Yu
- Clinical Virology Research Laboratory, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Dao Huang
- Clinical Virology Research Laboratory, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xue-Juan Zhu
- Clinical Virology Research Laboratory, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yue Han
- Clinical Virology Research Laboratory, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jie Chen
- Clinical Virology Research Laboratory, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Huang
- Clinical Virology Research Laboratory, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yong-Yan Chen
- Clinical Virology Research Laboratory, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qi-Ming Gong
- Department of Infectious Diseases, Institute of Infectious and Respiratory Diseases, Ruijin Hospital, School of Medicine Shanghai Jiao Tong University, Shanghai, China
| | - Jie-Hong Jiang
- Clinical Virology Research Laboratory, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Dong-Hua Zhang
- Clinical Virology Research Laboratory, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Zhang
- Ministry of Education Key Laboratory of Systems Biomedicine, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ji-Ming Zhang
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Xin-Xin Zhang
- Clinical Virology Research Laboratory, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Translational Medicine Research Center, Ruijin Hospital North, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Predictive role of serum HBsAg and HBcrAg kinetics in patients with HBeAg-negative chronic hepatitis B receiving pegylated interferon-based therapy. Clin Microbiol Infect 2017; 24:306.e7-306.e13. [PMID: 28750917 DOI: 10.1016/j.cmi.2017.07.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 07/12/2017] [Accepted: 07/16/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To investigate the role of serum hepatitis B core-related antigen (HBcrAg) kinetics in predicting long-term outcome of pegylated interferon (PEG-IFN)-based therapy in patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB). METHODS A total of 121 Thai patients with HBeAg-negative CHB recruited from a previous randomized trial of 48-week PEG-IFN alone or combined with entecavir were enrolled. Hepatitis B surface antigen (HBsAg) and HBcrAg levels were serially examined. Paired biopsy samples taken at baseline and after treatment were assessed for intrahepatic covalently closed circular DNA (cccDNA). RESULTS Persistent virologic remission (PVR, defined by persistent hepatitis B virus (HBV) DNA <2000 IU/mL) and HBsAg clearance at 3 years after treatment were 29% (35/121) and 9% (11/121) respectively. Baseline HBcrAg correlated with HBV DNA and cccDNA but not with HBsAg. Baseline HBsAg, as well as HBsAg and HBcrAg, declines were associated with PVR, while HBsAg decline was predictive of HBsAg clearance. High baseline antigen levels (HBsAg ≥3.4 log10 IU/mL plus HBcrAg ≥3.7 log10 U/mL) yielded high negative predictive values of PVR (45/50, 90%) and HBsAg clearance (50/50, 100%). At week 12, declines of HBsAg, HBcrAg and both antigens combined of <0.5 log10 yielded negative predictive values for PVR of 90% (71/79), 82% (61/74) and 96% (48/50) respectively. CONCLUSIONS Quantitative HBcrAg was significantly associated with cccDNA in HBeAg-negative CHB. This novel antigen, together with HBsAg, could identify patients with low probability of PVR and HBsAg clearance in long-term follow-up.
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Yan LB, Zhu X, Bai L, Tang XQ, Du LY, Chen EQ, Liang LB, Tang H. Mutations in basal core promoter is associated with significant fibrosis in both HBeAg positive and negative treatment-naïve chronic hepatitis B. Clin Res Hepatol Gastroenterol 2017; 41:296-302. [PMID: 27988305 DOI: 10.1016/j.clinre.2016.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 09/08/2016] [Accepted: 11/02/2016] [Indexed: 02/05/2023]
Abstract
AIM Assessment of liver fibrosis is important for the decision of whether to administrate antiviral treatment in chronic Hepatitis B (CHB) patients. The objective was to investigate the relationship between clinical factors and fibrosis, identify predictors of significant fibrosis in Chinese CHB patients. METHODS Two hundred and seventy-four treatment-naïve CHB patients (208 HBeAg-positive and 66 HBeAg-negative) who performed transient elastography were consecutively included. We assessed ALT, HBsAg, HBeAg, HBV-DNA, HBV genotype and precore (PC)/basal core promoter (BCP) variants and liver stiffness measurement (LSM) values. RESULTS One hundred and nine patients (39.78%) had significant fibrosis (F≥2, include those with liver cirrhosis). On univariate analysis, significant fibrosis was associated with older age (P<0.001), high ALT levels (P=0.003), lower HBsAg levels (P<0.001), lower HBV DNA levels (P<0.001), HBeAg negative (P<0.001), presence of BCP (P<0.001) and combined BCP/PC mutations (P=0.001). Multivariate logistic regression analysis showed that the strongest independently associated predictors of significant fibrosis (F≥2) were the presence of HBV BCP mutations (P<0.001) and older age (P<0.001), followed by presence of lower HBsAg (P<0.001), higher ALT levels (P=0.006), PC mutations (P=0.011). The diagnostic accuracy of the combination (age, ALT, HBsAg, BCP/PC variants) model with an area under the receiver-operating characteristic curve of 0.819 (cut-off value was 0.349, P<0.001, 95% CI 0.731-0.914) in predicting significant fibrosis. CONCLUSIONS We identified four independent risk factors (age, ALT, HBsAg, HBV BCP/PC variants) in predicting significant fibrosis. HBV BCP variants was the strongest predictor of significant fibrosis. The combination of these four variables may facilitate the assessment and management of fibrosis in HBV infected patients.
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Affiliation(s)
- Li-Bo Yan
- Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China; Division of Infectious Diseases, State Key Laboratory of Biotherapy, Sichuan University, Chengdu 610041, People's Republic of China
| | - Xia Zhu
- Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China; Division of Infectious Diseases, State Key Laboratory of Biotherapy, Sichuan University, Chengdu 610041, People's Republic of China
| | - Lang Bai
- Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China; Division of Infectious Diseases, State Key Laboratory of Biotherapy, Sichuan University, Chengdu 610041, People's Republic of China
| | - Xiao-Qiong Tang
- Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China; Division of Infectious Diseases, State Key Laboratory of Biotherapy, Sichuan University, Chengdu 610041, People's Republic of China
| | - Ling-Yao Du
- Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China; Division of Infectious Diseases, State Key Laboratory of Biotherapy, Sichuan University, Chengdu 610041, People's Republic of China
| | - En-Qiang Chen
- Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China; Division of Infectious Diseases, State Key Laboratory of Biotherapy, Sichuan University, Chengdu 610041, People's Republic of China
| | - Ling-Bo Liang
- Department of General Medicine, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Hong Tang
- Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China; Division of Infectious Diseases, State Key Laboratory of Biotherapy, Sichuan University, Chengdu 610041, People's Republic of China.
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Affiliation(s)
- Patrick Marcellin
- Service d'hépatologie, INSERM CRI, Université Paris-Diderot, Clichy, France
| | - Emilie Estrabaud
- Service d'hépatologie, INSERM CRI, Université Paris-Diderot, Clichy, France
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Osiowy C, Coffin C, Andonov A. Review of Laboratory Tests used in Monitoring Hepatitis B Response to Pegylated Interferon and Nucleos(t)ide Analog Therapy. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2016; 8:177-193. [PMID: 27547127 PMCID: PMC4969325 DOI: 10.1007/s40506-016-0080-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
There are only two currently approved classes of hepatitis B virus (HBV) antiviral agents, pegylated interferon (Peg-IFN), and nucleos(t)ide analogs (NAs) for chronic HBV infection. Although Peg-IFN is used for a finite 48-week duration and offers a greater chance of sustained off-treatment virological response, it is poorly tolerated and can only be offered to selected patients. The NAs are well tolerated but require prolonged therapy due to risk of relapse with treatment cessation. There is evolving data that novel virological assays (e.g., quantitative hepatitis B surface antigen, quantitative hepatitis B core antigen, quantitative antibody to core protein) in combination with hepatitis B genotype and more sensitive HBV DNA polymerase chain reaction (PCR) assays may be useful to predict response to IFN as well as off-treatment NA durability. Utilization of these clinical laboratory tests may be important given the development of novel anti-HBV therapies, hoping to achieve a cure for chronic hepatitis B infection.
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Affiliation(s)
- Carla Osiowy
- Bloodborne Pathogens and Hepatitis, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington St., Winnipeg, MB R3E 3R2 Canada
| | - Carla Coffin
- Liver Unit, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - Anton Andonov
- Bloodborne Pathogens and Hepatitis, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington St., Winnipeg, MB R3E 3R2 Canada
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