Hepatitis B core antigen expression pattern reflects the response to anti-viral treatment
Hepatitis B core antigen expression pattern reflects the response to anti-viral treatment
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DOI：
10.1111/j.1440-1746.2006.04263.x
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发表时间：
2006-06-01
影响因子：
4.1
通讯作者：
Uzunalimoglu, Ozden
中科院分区：
文献类型：
--
作者：
Uzun, Yusuf;Bozkaya, Hakan;Uzunalimoglu, Ozden
背景：在乙肝早期抗原(HBeAg)阴性的患者中，对当前治疗方案的应答预测因素还不是很清楚。肝细胞周期可能影响乙肝病毒复制和核心抗原表达，而核心抗原是抗病毒免疫反应的主要靶点。目的：探讨慢性乙型肝炎患者肝组织中HBcAg表达及肝细胞增殖率在抗病毒治疗中的作用。方法：33例慢性乙型肝炎患者(HBeAg阳性9例，HBeAg阴性24例)接受拉米夫定联合干扰素治疗或单用拉米夫定治疗。免疫组织化学方法检测肝组织增殖细胞核抗原和HBcAg的表达。用杂交法测定血清中的HBVdna水平。结果：治疗结束时，有效23例(67.7%)，持续有效12例，无效10例(33.3%)。在基线状态下，应答者和无应答者的年龄、性别、ALT、HBVDNA水平、HBeAg状态、组织学活动、纤维化评分和增殖细胞核抗原标记指数相似。在治疗结束时，有应答的患者中HBcAg阳性的人数低于无应答的患者(分别为17.4%和80%，P<；0.001)，尽管持续应答者和无应答的患者中HBcAg阳性的人数相似。结论：HBcAg表达缺失或低水平可能预示着当前治疗的结束，尤其是在HBe Ag(-)患者。增殖细胞核抗原测定不能预测治疗反应。
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 hybride 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.