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Journal of Clinical Microbiology, December 2007, p. 3942-3947, Vol. 45, No. 12
0095-1137/07/$08.00+0     doi:10.1128/JCM.00366-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Hepatitis B Virus Core-Related Antigens as Markers for Monitoring Chronic Hepatitis B Infection{triangledown}

Danny Ka-Ho Wong,1 Yasuhito Tanaka,2 Ching-Lung Lai,1 Masashi Mizokami,2 James Fung,1 and Man-Fung Yuen1*

Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong,1 Department of Clinical Molecular Informative Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan2

Received 16 February 2007/ Returned for modification 26 September 2007/ Accepted 5 October 2007

A sensitive chemiluminescence enzyme immunoassay has been developed for hepatitis B virus (HBV) core-related antigen (HBcrAg) detection. We aimed to investigate the usefulness of HBcrAg measurement for monitoring chronic hepatitis B disease. HBcrAg levels were measured by a chemiluminescence enzyme immunoassay in 54 untreated patients and 39 patients treated with either entecavir or lamivudine. The HBcrAg concentration correlated positively with the levels of serum HBV DNA (r = 0.820), intrahepatic total HBV DNA (r = 0.700), and covalently closed circular DNA (cccDNA) (r = 0.664; for all, P values were <0.001). A higher HBcrAg concentration was associated with a greater proportion of hepatitis B core antigen immunostaining. Although the differences were not statistically significant, patients with higher Knodell necroinflammation and fibrosis scores tended to have higher serum HBcrAg concentration levels. In the treated patients, the logarithmic reduction in HBcrAg at week 48 correlated positively with the logarithmic reduction of serum HBV DNA, intrahepatic total HBV DNA, and cccDNA. Of the 31 patients with undetectable serum HBV DNA (<300 copies/ml) at the end of treatment, 20 (65%) still had detectable HBcrAg. A greater reduction in posttreatment HBcrAg concentration was associated with histological improvement and a decrease in hepatitis B core antigen immunostaining. HBcrAg concentrations of <40,000 kU/ml at baseline and <200 kU/ml at week 24 were associated with a higher chance of having undetectable HBV DNA at week 48. In conclusion, serum HBcrAg levels correlated with HBV virological markers and reflected the chronic hepatitis B disease activity in the liver.

* Corresponding author. Mailing address: Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong SAR, China. Phone: (852) 28553984. Fax: (852) 28725828. E-mail: mfyuen{at}hkucc.hku.hk

{triangledown} Published ahead of print on 17 October 2007.

Journal of Clinical Microbiology, December 2007, p. 3942-3947, Vol. 45, No. 12
0095-1137/07/$08.00+0     doi:10.1128/JCM.00366-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.





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