Are alanine aminotransferase, hepatitis B virus DNA or IgM antibody to hepatitis B core antigen serum levels predictors of histological grading in chronic hepatitis B?
Paired sera and liver biopsies from 105 patients with chronic hepatitis B virus infection (34 HBeAg positive and 71 anti-HBe positive) were studied to investigate the relation between the degree of histological activity and alanine aminotransferase (ALT), hepatitis B virus DNA (HBV-DNA) or IgM antibody to hepatitis B core antigen (IgM anti-HBc) levels. ALT levels were significantly higher in patients with piecemeal necrosis (155 +/- 124 vs 75 +/- 42, p = 0.0017), but there were no differences in the ALT values of patients with or without intralobular necrosis. ALT values were within normal range in 29% of 31 patients without versus 15% of 65 with piecemeal necrosis (p = 0.19). Serum HBV-DNA levels were not related to the grade of lobular or portal/periportal activity in HBeAg-positive patients. Anti-HBe-positive subjects with piecemeal necrosis had higher HBV-DNA levels (34 +/- 93 vs 4 +/- 6, p = 0.01). IgM anti-HBc indexes were significantly higher in patients with intralobular necrosis (0.635 +/- 0.600 vs 0.356 +/- 0.367, p = 0.0005) or piecemeal necrosis (0.671 +/- 0.633 vs 0.321 +/- 0.219, p = 0.0002). In summary, since serum IgM anti-HBc-IMx indexes can reflect the grade of histological activity, the quantitative assessment of this antibody could be useful for non-invasive monitoring of hepatocellular damage in chronic hepatitis B.
Zavaglia
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C
Divisione di Medicina Generale e Servizio di Epatologia, Ospedale Niguarda Ca'Granda, Milan, Italy.
Mondazzi
L
L
Maggi
G
G
Iamoni
G
G
Gelosa
F
F
Bellati
G
G
Colloredo
G
G
Bottelli
R
R
Ideo
G
G
D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D015415:Biomarkers; D002908:Chronic Disease; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D006509:Hepatitis B / Q000097:blood* / Q000473:pathology; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006515:Hepatitis B virus; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood* / Q000276:immunology; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis
D000914:Antibodies, Viral; D015415:Biomarkers; D004279:DNA, Viral; D006512:Hepatitis B Core Antigens; D007075:Immunoglobulin M