Hepatitis B core antigen expression pattern reflects the response to anti-viral treatment.
BACKGROUND
In hepatitis B early antigen (HBeAg)-negative patients, response predictors to current treatment regimens are not well known. Hepatocyte cell cycle may influence hepatitis B virus (HBV) replication and hepatitis B core antigen (HBcAg) expression, which is a major target for antiviral immune response. The aim of the present paper was to evaluate the role of HBcAg expression in liver tissue and the rate of hepatocyte proliferation in response to antiviral treatment in chronic hepatitis B.


METHODS
A total of 33 chronic hepatitis B patients (nine HBeAg positive, 24 HBeAg negative) treated with either lamivudine and interferon combined or lamivudine alone were included. Liver expressions of proliferating cell nuclear antigen (PCNA) and HBcAg were immunohistochemically determined. The HBV-DNA levels were measured by a hybrid capture assay. Complete response was defined as alanine aminotransferase (ALT) normalization and HBV-DNA negativity.


RESULTS
At the end of treatment, 23 patients (67.7%) were responders (12 of 23 were sustained responders), while 10 (33.3%) were non-responders. Age, sex, ALT, HBV-DNA levels, HBeAg status, histological activity, fibrosis scores and PCNA labeling index were similar in responders versus non-responders at baseline. The number of patients with positive HBcAg staining was lower in responders compared to non-responders at the end of treatment (17.4% vs 80%, respectively, P < 0.001), although a similar number of sustained responders and non-responders had positive HBcAg staining.


CONCLUSIONS
Absence or a low level of HBcAg expression may predict the end of treatment response to current therapies, especially in HBeAg (-) patients. The PCNA determination does not predict treatment response.
Uzun
Yusuf
Y
Department of Gastroenterology, Faculty of Medicine, Karadeniz Technical University, Blok 30 Daire 11, 61080 Trabzon, Turkey. dryuzun@yahoo.com
Bozkaya
Hakan
H
Erden
Esra
E
Cinar
Kubilay
K
Idilman
Ramazan
R
Yurdaydin
Cihan
C
Uzunalimoglu
Ozden
O
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D049109:Cell Proliferation; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006510:Hepatitis B Antibodies / Q000097:blood; D006512:Hepatitis B Core Antigens / Q000032:analysis*; D019694:Hepatitis B, Chronic / Q000175:diagnosis* / Q000188:drug therapy*; D022781:Hepatocytes / Q000737:chemistry* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome
D000998:Antiviral Agents; D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens