HBeAg Levels Vary across the Different Stages of HBV Infection According to the Extent of Immunological Pressure and Are Associated with Therapeutic Outcome in the Setting of Immunosuppression-Driven HBV Reactivation
| Autor: | Carla Fontana, Patrick T F Kennedy, Elisa Basile, Carlotta Cerva, Valentina Svicher, Maria De Cristofaro, A. Iuvara, L. Piermatteo, Stefano D’Anna, Francesca Ceccherini-Silberstein, Mariantonietta Pisaturo, Loredana Sarmati, Carmine Minichini, Mohammad Alkhatib, Mario Starace, Romina Salpini, Eleonora Andreassi, Sandro Grelli, Massimo Andreoni, Upkar S. Gill, Ada Bertoli, Vincenzo Malagnino, Nicola Coppola, Giuseppina Cappiello |
|---|---|
| Přispěvatelé: | Piermatteo, Lorenzo, Alkhatib, Mohammad, D'Anna, Stefano, Malagnino, Vincenzo, Bertoli, Ada, Andreassi, Eleonora, Basile, Elisa, Iuvara, Alessandra, De Cristofaro, Maria, Cappiello, Giuseppina, Cerva, Carlotta, Minichini, Carmine, Pisaturo, Mariantonietta, Starace, Mario, Coppola, Nicola, Fontana, Carla, Grelli, Sandro, Ceccherini-Silberstein, Francesca, Andreoni, Massimo, Gill, Upkar S, Kennedy, Patrick T F, Sarmati, Loredana, Salpini, Romina, Svicher, Valentina, Piermatteo, L., Alkhatib, M., D'Anna, S., Malagnino, V., Bertoli, A., Andreassi, E., Basile, E., Iuvara, A., De Cristofaro, M., Cappiello, G., Cerva, C., Minichini, C., Pisaturo, M., Starace, M., Coppola, N., Fontana, C., Grelli, S., Ceccherini-Silberstein, F., Andreoni, M., Gill, U. S., Kennedy, P. T. F., Sarmati, L., Salpini, R., Svicher, V. |
| Rok vydání: | 2021 |
| Předmět: |
Treatment response
medicine.medical_specialty HBsAg QH301-705.5 medicine.medical_treatment viruses Hbv reactivation HBV reactivation Medicine (miscellaneous) HBeAg Gastroenterology General Biochemistry Genetics and Molecular Biology Article Internal medicine medicine HBV Biology (General) Natural course business.industry virus diseases Immunosuppression cccDNA Settore MED/17 digestive system diseases Chronic infection business |
| Zdroj: | Biomedicines Volume 9 Issue 10 Biomedicines, Vol 9, Iss 1352, p 1352 (2021) |
| ISSN: | 2227-9059 |
| Popis: | HBeAg is a marker of HBV-activity, and HBeAg-loss predicts a favorable clinical outcome. Here, we characterize HBeAg-levels across different phases of HBV infection, their correlation with virological/biochemical markers and the virological response to anti-HBV therapy. Quantitative HBeAg (qHBeAg, DiaSorin) is assessed in 101 HBeAg+ patients: 20 with acute-infection, 20 with chronic infection, 32 with chronic hepatitis and 29 with immunosuppression-driven HBV-reactivation (HBV-R). A total of 15/29 patients with HBV-R are monitored for > 12 months after starting TDF/ETV. qHBeAg is higher in immunosuppression-driven HBV-R (median[IQR]:930[206–1945]PEIU/mL) and declines in chronic hepatitis (481[28–1393]PEIU/mL, p = 0.03), suggesting HBeAg production, modulated by the extent of immunological pressure. This is reinforced by the negative correlation between qHBeAg and ALT in acute infection (Rho = −0.66, p = 0.006) and chronic hepatitis (Rho = −0.35 p = 0.05). Interestingly, qHBeAg strongly and positively correlates with qHBsAg across the study groups, suggesting cccDNA as a major source of both proteins in the setting of HBeAg positivity (with limited contribution of integrated HBV-DNA to HBsAg production). Focusing on 15 patients with HBV-R starting TDF/ETV, virological suppression and HBeAg-loss are achieved in 60% and 53.3%. Notably, the combination of qHBeAg > 2000 PEIU/mL + qHBsAg > 52,000 IU/mL at HBV-R is the only factor predicting no HBeAg loss (HBeAg loss: 0% with vs. 72.7% without qHBeAg > 52,000 IU/mL, p = 0.03). In conclusion, qHBeAg varies over the natural course of HBV infection, according to the extent of immunological pressure. In the setting of HBV-R, qHBeAg could be useful in predicting the treatment response under immunosuppression. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|