title: HBsAg expression of liver correlates with histological activities and viral replication in chronic hepatitis B.
abstract: BACKGROUND
  The intrahepatic hepatitis B surface antigens (HBsAg) expression is related to disease progression of chronic hepatitis B. We examined the features of intrahepatic HBsAg expression.
  
  
  METHODS
  A total of 181 patients with e antigen positive chronic hepatitis B were enrolled. Patterns and semi-quantitative measurement of intrahepatic HBsAg expression were analyzed. The association of intrahepatic hepatitis HBsAg expression with clinical, viral, and histological characteristics was evaluated.
  
  
  RESULTS
  Higher necroinflammation grade and greater fibrosis stage accompanied with lower serum HBV DNA and HBsAg levels were observed in patients with type II ground glass hepatocytes and 2+/3+ scales of intrahepatic HBsAg expression. Basal core promoter T1762/A1764 mutations were strongly associated with the pattern of type II ground glass hepatocytes expression (P < 0.001) and higher level of HBsAg expression (9.3 ± 8.0% vs. 4.3 ± 5.0%, P = 0.008). In multivariate analysis, basal core promoter mutations (Odds ratio: 6.356, 95% confidence interval: 1.204 ~ 33.356, P = 0.029) was associated with 2+/3+ scale of HBsAg expression.
  
  
  CONCLUSIONS
  Both pattern and levels of intrahepatic HBsAg expression were associated with severity of liver disease in e antigen positive chronic hepatitis B. Strong relationship between intrahepatic HBsAg expression and basal core promoter 1762/A1764 mutations indicated that HBsAg expression may be the histological manifestation of hepatitis B virus genomic evolution under host immune surveillance.
authors.affiliation: Department Internal Medicine, Institute of Medicine, Medical College of National Cheng Kung University. Taiwan.
authors.forename: Pin-Nan
authors.initials: PN
authors.lastname: Cheng
authors.affiliation: Department Internal Medicine, Institute of Medicine, Medical College of National Cheng Kung University. Taiwan.
authors.forename: Yen-Cheng
authors.initials: YC
authors.lastname: Chiu
authors.affiliation: Department of Pathology, Institute of Medicine, Medical College of National Cheng Kung University. Taiwan.
authors.forename: Hung-Wen
authors.initials: HW
authors.lastname: Tsai
authors.affiliation: Department of Family Medicine, Institute of Medicine, Medical College of National Cheng Kung University. Taiwan.
authors.forename: Ru-Hsueh
authors.initials: RH
authors.lastname: Wang
authors.affiliation: Department Internal Medicine, Institute of Medicine, Medical College of National Cheng Kung University. Taiwan.
authors.forename: Hung-Chih
authors.initials: HC
authors.lastname: Chiu
authors.affiliation: Department Internal Medicine, Institute of Medicine, Medical College of National Cheng Kung University. Taiwan.
authors.forename: I-Chin
authors.initials: IC
authors.lastname: Wu
authors.affiliation: Department Internal Medicine, Institute of Medicine, Medical College of National Cheng Kung University. Taiwan.
authors.forename: Ting-Tsung
authors.initials: TT
authors.lastname: Chang
mesh_terms: D000328:Adult; D004279:DNA, Viral / Q000097:blood*; D018450:Disease Progression; D005260:Female; D005838:Genotype; D006514:Hepatitis B Surface Antigens / Q000235:genetics / Q000378:metabolism*; D006515:Hepatitis B virus / Q000235:genetics* / Q000276:immunology / Q000502:physiology; D019694:Hepatitis B, Chronic / Q000097:blood / Q000378:metabolism* / Q000473:pathology; D022781:Hepatocytes / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011401:Promoter Regions, Genetic; D019562:Viral Load; D014779:Virus Replication
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens