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Volume 37 Issue 1
Jan.  2021
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Article Navigation >  Journal of Clinical Hepatology  > 2021  >  37(1): 46-50

Association of the expression of HBsAg and HBcAg in liver tissue with antiviral response in children with chronic hepatitis B

DOI: 10.3969/j.issn.1001-5256.2021.01.010
  • a.

    Division of Liver Diseases, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100093, China

  • b.

    Division of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100093, China

  • Received Date: 2020-07-07
  • Accepted Date: 2020-08-31
  • Published Date: 2021-01-20
    Abstract
  •   Objective  To investigate the association of the expression of HBsAg and HBcAg in liver tissue with antiviral response in children with chronic hepatitis B (CHB).  Methods  Clinical data were collected from 276 children, aged 6 months to 16 years, who were hospitalized and diagnosed with CHB in Department of Adolescent Liver Diseases in The Fifth Medical Center of Chinese PLA General Hospital from January 2014 to December 2017, and based on the results of immunohistochemical staining for HBsAg and HBcAg, there were 249 children in the positive HBsAg group, 27 in the negative HBsAg group, 163 in the positive HBcAg group, and 113 in the negative HBcAg group. Clinical features were compared between groups, as well as the difference in antiviral response between the children with different expression patterns of HBsAg and HBcAg in liver tissue. The Mann-Whitney U test was used for comparison of continuous data between groups, and the chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. A logistic regression analysis was performed with positive or negative staining of HBsAg and HBcAg in liver tissue as dependent variables and related significant factors affecting their expression intensity as independent variables.  Results  The age of 276 children ranged from 0.5 to 16 years, and there were 167 boys, accounting for 60.51%. Of all children, 14 (5.07%) had negative HBeAg. As for liver inflammation grade (G), 52.54% had G2 inflammation, 6.88% had G2-3 inflammation, and 7.61% had G3 inflammation; as for liver fibrosis stage (S), 7.25% had S3 fibrosis, 1.45% had S3-4 fibrosis, and 3.62% had S4 fibrosis. The positive HBsAg group had significantly higher age and serum HBsAg quantification than the negative HBsAg group (Z=1.854, Z=2.447, both P < 0.05). Compared with the negative HBcAg group, the positive HBcAg group had a significantly higher positive rate of HBeAg (χ2=2.650, P < 0.05) and significantly lower ALT (Z=2.473, P < 0.05), AST (Z= 1.813, P < 0.05), and proportion of children with S≥3 liver fibrosis (χ2=2.086, P < 0.05). The logistic regression analysis showed that serum HBsAg quantification was an influencing factor for positive HBsAg staining in liver tissue (P < 0.05) and negative or positive HBeAg was an influencing factor for positive HBcAg staining in liver tissue (P < 0.05). Among the 276 children, 186 completed the 6-month follow-up after antiviral therapy with IFNα or lamivudine alone, and 155 (83.33%) achieved HBeAg seroconversion, among whom 76 (40.86%) had HBsAg seroconversion. The higher the expression intensity of HBsAg in liver tissue, the lower the seroconversion rate of serum HBsAg; the higher the expression intensity of HBcAg in liver tissue, the lower the seroconversion rate of serum HBeAg. The children with negative expression of HBsAg and HBcAg in liver tissue had the highest HBsAg seroconversion rate of 100%, and the children with positive HBsAg and negative HBcAg in liver tissue had the lowest HBsAg seroconversion rate of 32.31%.  Conclusion  CHB children with negative HBsAg and HBcAg in liver tissue had the highest HBsAg seroconversion rate after antiviral therapy.

     

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