Journal of Viral Hepatitis, 2014, 21, 897–904
doi:10.1111/jvh.12218
Loss of intrahepatic HBsAg expression predicts sustained response to peginterferon and is reflected by pronounced serum HBsAg decline P. Arends,1 V. Rijckborst,1 P. E. Zondervan,2 E. Buster,1 Y. Cakaloglu,3 P. Ferenci,4 F. Tabak,5 U. S. Akarca,6 K. Simon,7 M. J. Sonneveld,1 B. E. Hansen1,8 and H. L. A. Janssen1,9 1Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; 2
Department of Pathology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; 3Istanbul Faculty of Medicine, Istanbul, Turkey;
4
Medical University of Vienna, Vienna, Austria; 5Cerrahpasa Medical Faculty, Istanbul, Turkey; 6Ege University Hospital, Izmir, Turkey; 7Katedra I
Klinika Chorob Zakaznych, Wroclaw, Poland; 8Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; and 9UHN Liver Clinic, Toronto Western and General Hospital University Health Network Toronto, Toronto, ON, Canada Received July 2013; accepted for publication October 2013
SUMMARY. There is a lack of knowledge regarding the effect of peginterferon (PEG-IFN) on the expression of intrahepatic hepatitis B core and surface antigen (HBcAg and HBsAg) in chronic hepatitis B (CHB) and its relation with response to therapy. Fifty-two HBeAg-positive and 67 HBeAg-negative CHB patients with paired liver biopsies taken at baseline and after 1 year of PEG-IFN therapy were studied. After PEG-IFN therapy, HBeAg-negative patients showed a significant reduction in both intrahepatic HBcAg (P = 0.04) and HBsAg expression (P < 0.001). In contrast, a reduction in intrahepatic HBcAg expression was not observed in HBeAgpositive patients, while a trend in reduction of intrahepatic HBsAg staining was found (P = 0.09). Post-treatment, 7 (13%) HBeAg-positive and 9 (14%) HBeAg-negative patients had no expression of intrahepatic HBsAg. Patients without any intrahepatic HBsAg expression post-treatment were more likely to achieve a combined response (HBeAg loss
INTRODUCTION Chronic hepatitis B (CHB) remains a major health problem affecting 350–400 million people worldwide and causing
Abbreviations: ALT, alanine aminotransferase; anti-HBe, antibody against HBeAg; cccDNA, covalently closed circular DNA; CHB, chronic hepatitis B; HBcAg, hepatitis B core antigen; HBeAg, hepatitis B e antigen; HBsAg, hepatitis B surface antigen; HBV, hepatitis B virus; PEG-IFN, peginterferon; ULN, upper limit of normal range. Correspondence: Harry L. A. Janssen, MD, PhD, Francis Family Chair in Hepatology, Professor of Medicine, University of Toronto & Erasmus University Rotterdam, Head of UHN Liver Clinic Division of Gastroenterology, University Health Network, 399 Bathurst Street, 6B FP, Room 164, Toronto, ON M5T 2S8, Canada. E-mail: [email protected]
© 2014 John Wiley & Sons Ltd
with hepatitis B virus (HBV) DNA
doi:10.1111/jvh.12218
Loss of intrahepatic HBsAg expression predicts sustained response to peginterferon and is reflected by pronounced serum HBsAg decline P. Arends,1 V. Rijckborst,1 P. E. Zondervan,2 E. Buster,1 Y. Cakaloglu,3 P. Ferenci,4 F. Tabak,5 U. S. Akarca,6 K. Simon,7 M. J. Sonneveld,1 B. E. Hansen1,8 and H. L. A. Janssen1,9 1Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; 2
Department of Pathology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; 3Istanbul Faculty of Medicine, Istanbul, Turkey;
4
Medical University of Vienna, Vienna, Austria; 5Cerrahpasa Medical Faculty, Istanbul, Turkey; 6Ege University Hospital, Izmir, Turkey; 7Katedra I
Klinika Chorob Zakaznych, Wroclaw, Poland; 8Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; and 9UHN Liver Clinic, Toronto Western and General Hospital University Health Network Toronto, Toronto, ON, Canada Received July 2013; accepted for publication October 2013
SUMMARY. There is a lack of knowledge regarding the effect of peginterferon (PEG-IFN) on the expression of intrahepatic hepatitis B core and surface antigen (HBcAg and HBsAg) in chronic hepatitis B (CHB) and its relation with response to therapy. Fifty-two HBeAg-positive and 67 HBeAg-negative CHB patients with paired liver biopsies taken at baseline and after 1 year of PEG-IFN therapy were studied. After PEG-IFN therapy, HBeAg-negative patients showed a significant reduction in both intrahepatic HBcAg (P = 0.04) and HBsAg expression (P < 0.001). In contrast, a reduction in intrahepatic HBcAg expression was not observed in HBeAgpositive patients, while a trend in reduction of intrahepatic HBsAg staining was found (P = 0.09). Post-treatment, 7 (13%) HBeAg-positive and 9 (14%) HBeAg-negative patients had no expression of intrahepatic HBsAg. Patients without any intrahepatic HBsAg expression post-treatment were more likely to achieve a combined response (HBeAg loss
INTRODUCTION Chronic hepatitis B (CHB) remains a major health problem affecting 350–400 million people worldwide and causing
Abbreviations: ALT, alanine aminotransferase; anti-HBe, antibody against HBeAg; cccDNA, covalently closed circular DNA; CHB, chronic hepatitis B; HBcAg, hepatitis B core antigen; HBeAg, hepatitis B e antigen; HBsAg, hepatitis B surface antigen; HBV, hepatitis B virus; PEG-IFN, peginterferon; ULN, upper limit of normal range. Correspondence: Harry L. A. Janssen, MD, PhD, Francis Family Chair in Hepatology, Professor of Medicine, University of Toronto & Erasmus University Rotterdam, Head of UHN Liver Clinic Division of Gastroenterology, University Health Network, 399 Bathurst Street, 6B FP, Room 164, Toronto, ON M5T 2S8, Canada. E-mail: [email protected]
© 2014 John Wiley & Sons Ltd
with hepatitis B virus (HBV) DNA
