Differential effect of chronic hepatitis D virus infection on intrahepatic expression of hepatitis B viral antigen.

Lau, Johnson Y. N.; Portmann, Bernard; Alexander, Graeme; Williams, Roger

doi:10.1136/jcp.45.4.314

Cited by 9 publications

(5 citation statements)

References 20 publications

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“…In HDV co-infection, intensity of HBsAg staining has been linked to earlier stages of disease and HBcAg positivity rates are low ( 15 ). The results from our cohort are consistent with previous reports of untreated chronic HDV patients, in which 6% of patients stained positive for HBcAg and 79.6% for HBsAg ( 14 ).…”

Section: Discussionsupporting

confidence: 93%

“…Surface antigen levels remained elevated even in the context of suppressed HBV DNA. In a previous study, once stratified for histological severity of liver disease, no difference with serum titers of HBsAg was found between HBV mono-infected and HDV patients ( 14 ).…”

Section: Discussionmentioning

confidence: 79%

“…In our cohort, the low percentage of HBcAg staining is consistent with the low levels of HBV viral expression. Absence of HBcAg in the liver has previously been associated with low levels of HBV viral replication and minimal inflammatory activity ( 14 , 23 ). A higher prevalence of HBcAg has been noted in the presence of higher viral loads in these cohorts ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

“…In HDV, patterns of expression of hepatic HBV antigens are affected by viral interference and suppression of HBV replication. Overall, in co-infected patients, a smaller proportion of cases stain positive for HBV antigen stains ( 13 , 14 ). Magnitude of HBsAg staining has also been associated with stages of liver disease in HDV ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

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Distinct histological patterns in chronic hepatitis D with nucleos(t)ide analogue therapy

et al. 2023

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BackgroundChronic hepatitis delta virus (HDV) infection leads to a more severe hepatitis than hepatitis B virus (HBV) infection alone. Specific histological staining patterns have been described in HBV mono-infection, however this has not been extensively investigated in HDV co-infection. This study evaluated whether the use of nucleos(t)ide analogs (NAs) for concurrent HBV infection has an impact on the histological appearance of chronic HDV.MethodsLiver biopsies of all patients referred for management of HDV infection were reviewed and hepatitis-specific stains for HBV antigens were evaluated. Clinical and histological characteristics were compared between patients on and off-NA therapy.Results50 patients were included in our analysis, of which 26 (52%) were on NA therapy at the time of the biopsy. Overall, 8% stained for HBV core antigen and 86% stained for HBV surface antigen. On and off-NA groups had similar degrees of fibrosis and inflammation, however NA patients had an odds ratio of 7.15 for membranous staining and 0.13 for scattered granular staining (p = 0.001). No association was found with markers of disease severity or viral activity, with nonetheless a lower score of total inflammation noted in biopsies with a positive membranous stain (8.5 vs. 10.3 p = 0.04).ConclusionIn chronic HDV infection, patients treated with nucleos(t)ide analogs demonstrate a unique membranous staining pattern for hepatitis B surface antigen, which is not associated with HBV or HDV replicative activity. These findings may help improve the understanding of the role of HBV directed therapy in HDV pathophysiology.HighlightsHistological staining is associated with viral activity in chronic HBV, however this has been infrequently explored in HDV. In HDV, staining patterns differ based on HBV treatment status and do not appear to be associated with markers of viral activity.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Distinct histological patterns in chronic hepatitis D with nucleos(t)ide analogue therapy

et al. 2023

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“…Delta virus antigen can be demonstrated in the liver tissues by IHC 11 . Chronic HDV infection affects intrahepatic expression of HBcAg but not of HBsAg 12 …”

Section: Immunohistochemistry In Viral Hepatitismentioning

confidence: 99%

Immunohistochemistry in liver diseases

Malhotra

Sakhuja

Gondal

2004

J of Gastro and Hepatol

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In 1975, Kohler-Milstein made a landmark contribution by demonstrating the production of monoclonal antibodies against antigens by hybridoma technology for which they were awarded Nobel Prize for Medicine in 1984. As these antibodies are specifically directed against single antigen, the technology is widely used for identifying phenotypic expression of genes by demonstrating proteins formed by them. Immunohistochemistry aims at identifying an antigen by specific antibody labeled with fluorescent material or enzyme which is demonstrated using a chromogen. This is an important tool in diagnostic histopathology and has an unlimited role in research. There is probably no other method that has revolutionized the field of pathology more over the last 50 years.Different immunohistochemical techniques are available.

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Loss of HBsAg with interferon‐α therapy in chronic hepatitis D virus infection

Lau

King

Tibbs

et al. 1993

Journal of Medical Virology

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Eleven patients with chronic hepatitis D virus (HDV) infection who had chronic active hepatitis and HDV antigen on liver biopsy were randomised in a crossover therapeutic trial of interferon-alpha 2b vs. no therapy. Nine patients had a history of intravenous drug use (drug free > 6 months before therapy), 8 had histological evidence of cirrhosis, and 7 out of 10 tested were found to be seropositive for antibody to hepatitis C virus (HCV). Six patients were randomised to receive interferon-alpha 2b therapy for 1 year, and 5 patients received no therapy for 1 year followed by the same regime of interferon-alpha 2b treatment. All patients with a history of intravenous drug use found self-injection stressful, 3 patients restarted using illicit drugs, and 2 patients with active cirrhosis developed severe thrombocytopenia during therapy and treatment was stopped in these patients. Of the 6 patients who completed at least 11 months of treatment, 4 lost serum hepatitis B surface antigen (HBsAg) with 3 developing antibody to HBsAg and one patient completing treatment. Among the 6 patients who had posttreatment liver biopsy, 5 showed an improvement in liver histology (3 of them lost serum HBsAg). These results provide further evidence that interferon-alpha is beneficial in chronic HDV infection although the psychological stress associated with the treatment, especially in patients with a previous history of intravenous drug use, is not inconceivable.

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Differential effect of chronic hepatitis D virus infection on intrahepatic expression of hepatitis B viral antigen.

Cited by 9 publications

References 20 publications

Distinct histological patterns in chronic hepatitis D with nucleos(t)ide analogue therapy

Distinct histological patterns in chronic hepatitis D with nucleos(t)ide analogue therapy

Immunohistochemistry in liver diseases

Loss of HBsAg with interferon‐α therapy in chronic hepatitis D virus infection

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