Preliminary research on the relationship between expression of HBV antigens and liver cell necrosis in the liver tissue of patients with chronic liver diseases

Intrahepatic HBVDNA replication and gene products expression correlated with foci of hepatic necrosis

Intrahepatic HBVDNA of patients with chronic hepatitis B was detected by in situ cytohybridization assay in combination with demonstration of HBsAg and HBcAg expression, and correlated with the foci of hepatic necrosis. It was found that HBsAg and HBcAg expressing sites appeared in the same areas where HBVDNA replicated; when HBsAg and HBcAg simultaneously expressed in the liver, one antigen usually dominated, the other declined. This unbalanced expression may be caused by the gene or transcripts variance which encodes the surface or core antigen, or by the activity of each replication. The other observation is that HBVDNA-positive hepatocytes outnumbered liver cells containing HBsAg and HBcAg in a few cases. It is supposed that a part of cytoplasmic HBVDNA was on replicative phase with gene production expression, on the contrary, another part of cytoplasmic HBVDNA may be out of replication with no gene product expression during chronic hepatitis B. Finally HBsAg and HBcAg expressing sites corresponding to HBVDNA-positive hepatocytes were closely attached to the foci of hepatic necrosis. There was no significant difference in the frequency of HBsAg and HBcAg expression correlating to hepatic necrosis.

Hepatocyte necrosis associated with HBV marker expression and T cytotoxic cells in situ in chronic hepatitis B

To explore the role of HBV antigen expression and monocyte infiltrate in situ in chronic hepatitis, HBV markers and compositions and number of monocytes in the liver of chronic hepatitis B were immunohistochemically located and identified, and correlated with hepatocyte necrosis. It was found that hepatic necrosis frequently took place in the centre or boundary of membranous HBsAg and/or HBcAg expression and the majority of monocytes accumulated in the necrotic areas showed CD8+ cell token in HBeAg-positive stage of chronic active hepatitis. On the other hand, with HBeAg positivity converted into HBeAg-negativity or anti-HBe-positivity, HBV antigen expression significantly declined, CD4+ cells remarkably increased as compared to HBeAg-positive status. These findings suggest that there may be distinct pathogenesis of hepatic necrosis in different stages of chronic HBV infection.

Expression and clinical significance of pre-S1 and S2 proteins of HBV in sera of patients with chronic liver disease

To assess the significance of pre-S proteins expression during chronic hepatitis B virus (HBV) infection, we developed a sensitive labeled avidin biotin ELISA to detect pre-S1 and pre-S2 proteins. In serum specimens from 80 patients with chronic liver disease, the frequency of pre-S1 and S2 proteins was 53.7% and 47.5%, respectively. Furthermore, it reached 87.8% and 77.6%, respectively, in cases with chronic HBV infection, indicating that pre-S proteins are usually expressed in sera with chronic HBV infection. We found that the expression of pre-S proteins is closely associated with HBV replicating markers, such as HBV DNA, HBcAg and HBeAg, in sera of patients with chronic HBV infection. Both pre-S1 and S2 proteins were often concurrently expressed in liver and serum with chronic HBV infection. However, the frequency was slightly higher in liver than in serum, suggesting that it may be clinically valuable to detect pre-S proteins in serum and liver simultaneously to determine the status of HBV infection. Our results also indicated that pre-S proteins expression in serum can serve as markers of HBV infection, but cannot be used to estimate the severity and activity of hepatic pathology.