Correlation of hepatocyte expression of hepatitis B viral antigens with histological activity and viral titer in chronic hepatitis B virus infection: An immunohistochemical study

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Correlation of hepatocyte expression of hepatitis B viral antigens with

histological activity and viral titer in chronic hepatitis B virus infection: An

immunohistochemical study

Authors: Ramakrishna, Banumathi1; Mukhopadhya, Ashis2; Kurian, 2

Source: Journal of Gastroenterology and Hepatology, Volume 23, Number 11,

November 2008 , pp. 1734-1738(5)

Publisher: Blackwell Publishing

Abstract:

Background and Aim: 

The localization of hepatitis B virus (HBV) core antigen to the nucleus or

cytoplasm of hepatocytes has biological implications for viral packaging and

persistence. This study examined the relationship between the localization of

hepatitis B virus antigens, histological activity, and viral titer in patients

with chronic HBV infection.

Methods: 

Liver biopsies from 110 patients with chronic HBV infection were studied.

Ishak's scoring system was used for the histological analysis. The localization

of hepatitis B surface antigen (HBsAg) and hepatitis B core antigen (HBcAg) and

the percentage of hepatocytes stained positive by immunohistochemistry were

correlated with viral titer, histological activity, and fibrosis indices using

Spearman rank correlation.

Results: 

In 88 hepatitis B e-antigen (HBeAg)-positive individuals, the nuclear

localization of HBcAg correlated significantly with DNA titer (r = 0.435,

P = 0.001) and negatively with fibrosis (r = −0.297, P = 0.005).

The cytoplasmic localization correlated significantly with histological activity

(r = 0.211, P = 0.049). In 22 HBeAg-negative individuals, the nuclear

localization of HBcAg correlated significantly with histological activity

(r = 0.625, P = 0.002), DNA titer (r = 0.651, P = 0.009), and

fibrosis (r = 0.447, P = 0.042). The cytoplasmic localization correlated

significantly with DNA titer (r = 0.524, P = 0.045) and fibrosis

(r = 0.528, P = 0.012). There was no correlation of HBsAg expression

with DNA titer, histological activity index, or fibrosis in both groups.

HBeAg-positive patients presented at a younger age.

Conclusion: 

In HBeAg-positive individuals, nuclear core antigen correlated with DNA titer,

and cytoplasmic localization with histological activity, whereas in

HBeAg-negative individuals, nuclear localization correlated with DNA titer,

histological activity, and fibrosis, and cytoplasmic localization correlated

with DNA titer and fibrosis, but not with histological activity. These

observations suggest biological differences between HBeAg-positive and -negative

disease.