title: Autoantibodies in Chinese patients with chronic hepatitis B: prevalence and clinical associations.
abstract: OBJECTIVE
  To investigate the prevalence of autoantibodies and their associations with clinical features in Chinese patients with chronic hepatitis B (CHB).
  
  
  METHODS
  A total of 325 Chinese patients with CHB were enrolled in this retrospective, hospital-based study. Patients with chronic hepatitis C (CHC), autoimmune hepatitis (AIH), or primary biliary cirrhosis (PBC) were included, with healthy donors acting as controls. A panel of autoantibodies that serologically define AIH and PBC was tested by indirect immunofluorescence assay and line immunoassay. The AIH-related autoantibody profile included homogeneous anti-nuclear antibodies (ANA-H), smooth-muscle antibodies, anti-liver kidney microsome type 1, anti-liver cytosolic antigen type 1, and anti-soluble liver antigen/liver pancreas; the PBC-related antibodies were characterized by ANA-nuclear dots/membranous rim-like, anti-mitochondrial antibodies-M2 (AMA-M2), anti-BPO (recombinant antigen targeted by AMA-M2), anti-Sp100, anti-promyelocytic leukemia protein (anti-PML), and anti-gp210. The dichotomization of clustering was used to unequivocally designate the AIH or PBC profiles for each case. Anti-Ro52 antibodies were also tested.
  
  
  RESULTS
  The prevalence of any autoantibody in CHB amounted to 58.2%, which was similar to the 66.2% prevalence in CHC, significantly higher than the 6.7% in the healthy controls (P < 0.001), and lower than the 100% found in AIH and PBC (P = 0.004 and P < 0.001, respectively). There were more anti-PML and anti-gp210 antibodies among the CHB patients than the CHC patients (11.1% vs 0%, P = 0.003; 12.6% vs 0%, P < 0.001, respectively). The prevalence and titer of AMA, anti-BPO, anti-PML, and anti-gp210 were higher in PBC than in those with CHB. Among the CHB patients, the prevalence of ANA, especially ANA-H, was significantly lower in patients with compensated and decompensated cirrhosis compared with patients without cirrhosis. Thirty-eight cases of hepatocellular carcinoma (HCC) in CHB showed a significant difference compared with non-HCC patients in the prevalence of anti-PML (0% vs 12.5%, P = 0.013). Dichotomization of the autoantibodies revealed that the PBC profile was more prevalent in patients with CHB than in those with CHC, and that it was strongly correlated with both compensated and decompensated cirrhosis. In contrast, the prevalence of the AIH profile was significantly higher in non-cirrhosis patients with CHB than in those with compensated cirrhosis (18.5% vs 8.2%, P = 0.039). Moreover, the AIH profile was also closely associated with hepatitis B e-antigen positivity.
  
  
  CONCLUSIONS
  ANA-H could be an indicator of early-stage CHB. Dichotomizing the autoantibody profiles revealed that the PBC profile is strongly associated with cirrhosis in CHB.
authors.affiliation: Bo-An Li, Jia Liu, Jun Hou, Jian Zhang, Jun Xu, Yong-Ji Song, Ai-Xia Liu, Jing Zhao, Jing-Xia Guo, Lin Chen, Han Wang, Li-Hua Yang, Yuan-Li Mao, Center of Clinical Laboratory Medicine, 302 Military Hospital of China, Beijing 100039, China.
authors.forename: Bo-An
authors.initials: BA
authors.lastname: Li
authors.affiliation: Bo-An Li, Jia Liu, Jun Hou, Jian Zhang, Jun Xu, Yong-Ji Song, Ai-Xia Liu, Jing Zhao, Jing-Xia Guo, Lin Chen, Han Wang, Li-Hua Yang, Yuan-Li Mao, Center of Clinical Laboratory Medicine, 302 Military Hospital of China, Beijing 100039, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Liu
authors.affiliation: Bo-An Li, Jia Liu, Jun Hou, Jian Zhang, Jun Xu, Yong-Ji Song, Ai-Xia Liu, Jing Zhao, Jing-Xia Guo, Lin Chen, Han Wang, Li-Hua Yang, Yuan-Li Mao, Center of Clinical Laboratory Medicine, 302 Military Hospital of China, Beijing 100039, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Hou
authors.affiliation: Bo-An Li, Jia Liu, Jun Hou, Jian Zhang, Jun Xu, Yong-Ji Song, Ai-Xia Liu, Jing Zhao, Jing-Xia Guo, Lin Chen, Han Wang, Li-Hua Yang, Yuan-Li Mao, Center of Clinical Laboratory Medicine, 302 Military Hospital of China, Beijing 100039, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Tang
authors.affiliation: Bo-An Li, Jia Liu, Jun Hou, Jian Zhang, Jun Xu, Yong-Ji Song, Ai-Xia Liu, Jing Zhao, Jing-Xia Guo, Lin Chen, Han Wang, Li-Hua Yang, Yuan-Li Mao, Center of Clinical Laboratory Medicine, 302 Military Hospital of China, Beijing 100039, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Bo-An Li, Jia Liu, Jun Hou, Jian Zhang, Jun Xu, Yong-Ji Song, Ai-Xia Liu, Jing Zhao, Jing-Xia Guo, Lin Chen, Han Wang, Li-Hua Yang, Yuan-Li Mao, Center of Clinical Laboratory Medicine, 302 Military Hospital of China, Beijing 100039, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Xu
authors.affiliation: Bo-An Li, Jia Liu, Jun Hou, Jian Zhang, Jun Xu, Yong-Ji Song, Ai-Xia Liu, Jing Zhao, Jing-Xia Guo, Lin Chen, Han Wang, Li-Hua Yang, Yuan-Li Mao, Center of Clinical Laboratory Medicine, 302 Military Hospital of China, Beijing 100039, China.
authors.forename: Yong-Ji
authors.initials: YJ
authors.lastname: Song
authors.affiliation: Bo-An Li, Jia Liu, Jun Hou, Jian Zhang, Jun Xu, Yong-Ji Song, Ai-Xia Liu, Jing Zhao, Jing-Xia Guo, Lin Chen, Han Wang, Li-Hua Yang, Yuan-Li Mao, Center of Clinical Laboratory Medicine, 302 Military Hospital of China, Beijing 100039, China.
authors.forename: Ai-Xia
authors.initials: AX
authors.lastname: Liu
authors.affiliation: Bo-An Li, Jia Liu, Jun Hou, Jian Zhang, Jun Xu, Yong-Ji Song, Ai-Xia Liu, Jing Zhao, Jing-Xia Guo, Lin Chen, Han Wang, Li-Hua Yang, Yuan-Li Mao, Center of Clinical Laboratory Medicine, 302 Military Hospital of China, Beijing 100039, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Bo-An Li, Jia Liu, Jun Hou, Jian Zhang, Jun Xu, Yong-Ji Song, Ai-Xia Liu, Jing Zhao, Jing-Xia Guo, Lin Chen, Han Wang, Li-Hua Yang, Yuan-Li Mao, Center of Clinical Laboratory Medicine, 302 Military Hospital of China, Beijing 100039, China.
authors.forename: Jing-Xia
authors.initials: JX
authors.lastname: Guo
authors.affiliation: Bo-An Li, Jia Liu, Jun Hou, Jian Zhang, Jun Xu, Yong-Ji Song, Ai-Xia Liu, Jing Zhao, Jing-Xia Guo, Lin Chen, Han Wang, Li-Hua Yang, Yuan-Li Mao, Center of Clinical Laboratory Medicine, 302 Military Hospital of China, Beijing 100039, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Chen
authors.affiliation: Bo-An Li, Jia Liu, Jun Hou, Jian Zhang, Jun Xu, Yong-Ji Song, Ai-Xia Liu, Jing Zhao, Jing-Xia Guo, Lin Chen, Han Wang, Li-Hua Yang, Yuan-Li Mao, Center of Clinical Laboratory Medicine, 302 Military Hospital of China, Beijing 100039, China.
authors.forename: Han
authors.initials: H
authors.lastname: Wang
authors.affiliation: Bo-An Li, Jia Liu, Jun Hou, Jian Zhang, Jun Xu, Yong-Ji Song, Ai-Xia Liu, Jing Zhao, Jing-Xia Guo, Lin Chen, Han Wang, Li-Hua Yang, Yuan-Li Mao, Center of Clinical Laboratory Medicine, 302 Military Hospital of China, Beijing 100039, China.
authors.forename: Li-Hua
authors.initials: LH
authors.lastname: Yang
authors.affiliation: Bo-An Li, Jia Liu, Jun Hou, Jian Zhang, Jun Xu, Yong-Ji Song, Ai-Xia Liu, Jing Zhao, Jing-Xia Guo, Lin Chen, Han Wang, Li-Hua Yang, Yuan-Li Mao, Center of Clinical Laboratory Medicine, 302 Military Hospital of China, Beijing 100039, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Lu
authors.affiliation: Bo-An Li, Jia Liu, Jun Hou, Jian Zhang, Jun Xu, Yong-Ji Song, Ai-Xia Liu, Jing Zhao, Jing-Xia Guo, Lin Chen, Han Wang, Li-Hua Yang, Yuan-Li Mao, Center of Clinical Laboratory Medicine, 302 Military Hospital of China, Beijing 100039, China.
authors.forename: Yuan-Li
authors.initials: YL
authors.lastname: Mao
mesh_terms: D000328:Adult; D044466:Asian People; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000208:ethnology / Q000276:immunology / Q000821:virology; D002681:China / Q000453:epidemiology; D003937:Diagnosis, Differential; D005260:Female; D006513:Hepatitis B e Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000097:blood / Q000175:diagnosis / Q000208:ethnology* / Q000276:immunology*; D019693:Hepatitis, Autoimmune / Q000097:blood / Q000208:ethnology / Q000276:immunology; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000208:ethnology / Q000276:immunology / Q000821:virology; D008105:Liver Cirrhosis, Biliary / Q000097:blood / Q000208:ethnology / Q000276:immunology; D008113:Liver Neoplasms / Q000097:blood / Q000208:ethnology / Q000276:immunology / Q000821:virology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D006513:Hepatitis B e Antigens
keywords: Autoantibodies; Autoimmune hepatitis; Chronic hepatitis B; Cirrhosis; Hepatocellular carcinoma; Primary biliary cirrhosis