Hepatic expression of viral antigens, hepatocytic proliferative activity and histologic changes in liver biopsies of children with chronic hepatitis B after interferon-alpha therapy.
OBJECTIVE
The purpose of the present study was to evaluate the effects of interferon-alpha (IFNalpha) treatment on necro-inflammatory changes, viral antigen expression and hepatocytic proliferation rate assessed by Ki-67 protein in liver biopsies of children with chronic hepatitis B virus (HBV) infection.


METHODS
The study included 18 children at prepubertal age. Histologic changes were assessed using a modified scoring system for grading of histological activity index and staging of fibrosis. The hepatocytic expression of Ki-67 and HBV antigens including HBV surface antigen (HBsAg) and HBV core antigen (HBcAg) were evaluated using a semi-quantitative immunohistochemical scoring system.


RESULTS
We found a significant decrease in the scores of intralobular confluent and spotty necrosis, periportal piecemeal necrosis, and in Ki-67 immunopositivity after treatment. Serologic response with clearance of HBV e antigen in 9 patients (50%) was associated with this improvement. The extent of fibrosis and scoring of portal inflammation, however, did not show any difference. HBcAg expression showed a significant decrease after treatment, whereas HBsAg expression either increased or remained unchanged.


CONCLUSIONS
We conclude that IFNalpha treatment might provide an improvement in hepatic histology with a reduction in hepatocytic injury. It might also provide a serologic response associated with a decrease in hepatocytic HBV replication.
Ozer
E
E
Department of Pathology, Dokuz Eylül University Hospital, Izmir, Turkey.
Ozer
E
E
Helvaci
M
M
Yaprak
I
I
D000998:Antiviral Agents / Q000627:therapeutic use*; D001706:Biopsy; D002455:Cell Division; D002648:Child; D002675:Child, Preschool; D005260:Female; D006512:Hepatitis B Core Antigens / Q000378:metabolism*; D006514:Hepatitis B Surface Antigens / Q000378:metabolism*; D006515:Hepatitis B virus / Q000378:metabolism*; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007124:Immunoenzyme Techniques; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D019394:Ki-67 Antigen / Q000378:metabolism; D008099:Liver / Q000378:metabolism* / Q000473:pathology; D008103:Liver Cirrhosis / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology; D008297:Male; D011994:Recombinant Proteins; D016896:Treatment Outcome
D000998:Antiviral Agents; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D019394:Ki-67 Antigen; D011994:Recombinant Proteins