Subcellular localizaton of HBcAg have been found to be related to the activity of liver disease and HBV replication. The aim of this study was to determine whether the degree of expression of HBcAg in the hepatocyte nucleus and cytoplasm reflects the level of viral replication and histological activity in chronic HBV infection. A total of 102 patients with biopsy proven chronic hepatitis B were included. There was a highly significant correlation between the levels of HBV DNA in serum and the degree of expression of HBcAg in the nucleus for HBeAg-positive(p=0.000) and negative patients(p=0.04). There was a highly significant, correlation between the degrees of expression of HBcAg in hepatocyte cytoplasm and histologic activities (p<0.01) for HBeAg-positive patients. The degrees of expression of HBcAg in the hepatocyte cytoplasm correlated positively with the lobular activities (p<0.01), but not correlated with the portal activity and fibrosis for HBeAg-negative patients. In conclusion, in the young patients with chronic B viral hepatitis, the degree of expression of HBcAg in the hepatocyte nucleus may affect viral load, and the degree of expression of HBcAg in the hepatocyte cytoplasm may affect histologic activities of liver disease.
Male ; Liver/pathology/virology ; Humans ; Hepatocytes/pathology/*virology ; Hepatitis B, Chronic/*pathology/*virology ; Hepatitis B e Antigens/metabolism ; Hepatitis B Core Antigens/*metabolism ; DNA, Viral/blood ; Cytoplasm/virology ; Cell Nucleus/virology ; Adult ; Adolescent

No abstract available.
Biopsy, Fine-Needle ; Hepatitis B virus ; Hepatitis B, Chronic/*complications ; Hepatocytes/*pathology ; Humans ; Liver Cirrhosis/diagnosis/*pathology/virology ; Risk Factors

<b>OBJECTIVEb>To study the correlations between clinical features and liver pathohistological changes of chronic hepatitis B virus (HBV) carriers and to discuss the factors which may influence the prognosis.

<b>METHODSb>Ninety HBV carriers who had liver biopsies were enrolled in this study.

<b>RESULTSb>(1) The mean follow-up period of the patients was 118 weeks. (2) Fifty-four patients (60.0%) had G1 hepatitis and 21 (23.3%) had G2 hepatitis. The fibrosis stages were graded as S1(42) and S2(21). (3) There were significant age differences among S0, S1 and S2. (4) There were significant differences in aminotransferase levels between patients who had a normal liver histology and those who had mild hepatitis. (5) The grades of liver inflammation were not correlated with the titers of HBeAg and HBV DNA in sera. The stages of liver fibrosis were not correlated with the titers of HBVDNA in sera. Most of the HBeAg negative patients progressed to S2. (6) There were significant differences in spleen dimensions measured by ultrasonography between S0, S1 and S2 patients. (7) During the follow-up period serum aminotransferase (ALT) levels remained normal in 60 patients (group A); 22 patients had transient elevations (group B), and 8 patients had persistent increases (group C). There were significant differences of the ratios of S0 and S2 cases among patients in groups A, B and C. (8) Age and fibrosis stages were predictive factors of liver cirrhosis.

<b>CONCLUSIONSb>Most chronic HBV carriers had mild inflammatory histological changes in their livers and also had different degrees of liver fibrosis. This follow-up study shows that some of those carriers should have had antiviral therapy.

Adult ; Carrier State ; diagnosis ; pathology ; virology ; Female ; Hepatitis B virus ; Hepatitis B, Chronic ; diagnosis ; pathology ; Humans ; Liver Cirrhosis ; diagnosis ; pathology ; virology ; Male ; Middle Aged ; Prognosis

Hepatocellular carcinoma (HCC) is one of the most common cancer worldwide. Most of the HCC occur in developing countries. Chronic hepatitis B virus (HBV) infection is an important risk factor for HCC development. HBV induces immune-mediated chronic hepatitis, liver injury, regeneration and scar forming responses, leading to an inflammatory, fibrotic and immune deficient microenvironment. HBV may integrate into host genome, inducing genetic abnormality and altering the expression of HCC-related genes. HBV also expresses active proteins such as X (HBx) and S proteins, which may trans-activate HCC-related proteins expression, interact with intracellular specific proteins, activate a variety of signaling pathways, and induce aberrant epigenetic modifications. HBV mutation also has impact on HBV related HCC development.
Carcinoma, Hepatocellular ; pathology ; virology ; Epigenesis, Genetic ; Hepatitis B virus ; Hepatitis B, Chronic ; pathology ; Humans ; Liver Neoplasms ; pathology ; virology ; Mutation ; Signal Transduction ; Trans-Activators

Adult ; Aged ; B-Lymphocytes ; pathology ; Female ; Gastric Mucosa ; pathology ; Hepatitis B, Chronic ; complications ; epidemiology ; virology ; Hepatitis C, Chronic ; complications ; epidemiology ; virology ; Humans ; Immunohistochemistry ; Liver ; pathology ; Lymphoma ; etiology ; pathology ; virology ; Male ; Middle Aged ; Staining and Labeling

OBJECTIVE: To investigate the correlation between the content of hepatitis B virus DNA(HBV-DNA) in the serum and the pathologic change in hepatitis B virus associated-glomerulonephritis (HBV-GN). METHODS: Forty one HBV-GN patients were divided into 3 groups by the content of HBV-DNA in the serum:low replicate group,midrange replicate group, and high replicate group. The relationship with the content of HBV-DNA in the serum and pathologic stage or change was analyzed in 35 membranous glomerulopathy patients; Effect of the content of hepatitis B virus DNA in the serum on HBVAg deposition in glomeruli of kidney was examined by immunohistochemistry; Effect of HBVAg deposition on pathologic change was observed in membranous glomerulopathy patients. RESULTS: With the multiplication of HBV-DNA in the serum, the pathologic lesion was aggravating from Stage I to Stage III in membranous glomerulopathy patients; the deposition of HBVAg in glomeruli of kidney was increasing; with the increasing of deposition of HBVAg in glomeruli of kidney, the pathologic lesion was aggravating in membranous glomerulopathy patients. CONCLUSION With the multiplication of HBV-DNA in the serum, the deposition of HBVAg in glomeruli of kidney increases, and the pathologic lesion aggravates, which have significant correlation.
Adolescent ; Adult ; DNA, Viral ; blood ; Female ; Glomerulonephritis, Membranous ; pathology ; virology ; Hepatitis B virus ; physiology ; Hepatitis B, Chronic ; complications ; virology ; Humans ; Male ; Middle Aged ; Virus Replication

<b>OBJECTIVEb>To investigate the distribution of hepatitis B virus (HBV) genotype in Guizhou and to study the relationship between the genotype and the progression of liver disease.

<b>METHODSb>786 patients with chronic HBV infection, from 4 cities of Guizhou, including 346 asymptomatic carriers (ASC), 313 chronic hepatitis (CH), 77 liver cirrhosis (LC), 50 hepatocellular carcinoma (HCC) were examined. HBV genotype was determined by restriction fragment length polymorphism analysis and the subtypes were determined by direct sequencing of PCR product in 94 patients with HBV B genotype, the relationship between HBV genotype and the progression of liver disease was studied by multifactor analysis such as HBeAg positivity, HBV DNA load and ALT level.

<b>RESULTSb>Of the 786 patients, 7 (0.89%), 497 (63.23%), 275 (34.99%), and 7 (0.89%) belonged to genotype A, B, C, D, respectively. There was statistically significant difference in the distribution of genotype B among Kaili (96.04%), Zunyi (78.79%), Duyun (64.52%) and Guiyang (53.14%) (P< 0.01). Genotype C was more prevalent in Guiyang than in other three cities (P < 0.01, or P < 0.05). Out of 94 genotypes B, 93 (98.94%) belonged to subtype Ba, only one was subtype Bj. There were statistically significant difference in the distribution of genotype B and C among various stage of liver disease (P < 0.05 or P < 0.01). Genotype B showed a gradual decrease from ASC, CH, LC to the HCC group while in contrast, genotype C showed a gradual increase in the same order. The ALT levels and the mean age were significantly higher and older in patients with genotype C than those in genotype B (P < 0.01 or 0.05). The HBeAg positivity was significantly lower in genotype C than that in genotype B (P < 0.025).

<b>CONCLUSIONb>Data showed that there were genotype A, B, C and D existing in Guizhou. Genotype B was the major one but genotype C was more commonly seen. In genotype B, subtype Ba appeared to be predominant. The geographic distribution of genotype B and C were different in some cities of Guizhou. Compared to genotype B, genotype C was associated with the development of more severe liver damage.

Carcinoma, Hepatocellular ; pathology ; virology ; DNA, Viral ; analysis ; Disease Progression ; Genotype ; Hepatitis B virus ; classification ; genetics ; Hepatitis B, Chronic ; genetics ; pathology ; Humans ; Liver ; pathology ; Liver Cirrhosis ; pathology ; virology ; Liver Neoplasms ; pathology ; virology ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length

<b>OBJECTIVEb>To investigate the relationship between hepatic histopathological changes and clinical characteristics in chronic HBV carriers.

<b>METHODb>A retrospective analysis was performed based on the hepatic biopsy findings, clinical laboratory results, and ultrasound examinations in 142 chronic HBV carriers. The patients were divided into two groups according to their serum HBV DNA replication and the pathological alterations in their livers.

<b>RESULTSb>The average age of the 142 patients was (24.8+/-8.7) years old. Among them, 129 were diagnosed as chronic HBV carriers based on their positive HBV DNA results. Thirteen were diagnosed as non-active HBsAg carriers. Hepatitis B family history was found in 31.0% of the cases. Normal liver tissues (G0S0) were found in the specimens of 33 cases (G > or = 1 and/or S > or = 1) chronic hepatitis B was diagnosed based on the biopsies in 106 cases, including an early stage of hepatic cirrhosis in 1 case (G4S4). There were no obvious differences between HBV DNA positive and negative group cases. The levels of HBV DNA in all the 129 cases of chronic HBV carriers were more than 1.0 x 10(4) copy/ml and the average value was (7.58+/-0.99) log10 copy/ml. Of the 129 cases, 123 were HBeAg positive (95.3%). Increased levels of gamma-globulin were detected in 45.8% of the cases and fibrosis index increased in 37.1%; 40.1% of the cases showed abnormalities in their ultrasound examinations. The average PCIII value of the chronic HBV carrier group (G > or = 1 and/or S > or = 1) was higher than that of the non-active HBsAg carrier group (P = 0.016). Spearman's analysis indicated that the inflammation grade (G) was correlated with the hepatic fibrosis index PCIII, and the correlation coefficient was 0.391 (P = 0.003).

<b>CONCLUSIONb>The patients in our study have a higher HBV DNA replication in their sera and have mild inflammation in their livers. Inflammation grade (G) and fibrosis stage (S) have no correlation with the level of HBV DNA or the state of HBeAg positivity. The increased level of PCIII might be related to their hepatic inflammation.

Adolescent ; Adult ; Carrier State ; pathology ; Child ; Female ; Hepatitis B virus ; Hepatitis B, Chronic ; pathology ; virology ; Humans ; Liver ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

<b>OBJECTIVEb>To study the liver histopathological features of chronic HBV carriers and inactive HBsAg carriers.

<b>METHODSb>Liver biopsies were performed on 189 chronic HBV carriers and 30 inactive HBsAg carriers (219 cases in total). All of them had a normal serum ALT value; they were then followed-up for more than 6 months. HBsAg and HBcAg were detected by immunohistochemistry. The circulating HBV DNA loads and serologic markers of HBV were examined at the same time. Grades of liver necrosis/inflammation and fibrosis were compared between the patients regarding their HBV DNA positivity or negativity. The relationships between the HBeAg positivity and degrees of liver histological changes were evaluated. The grades of liver necrosis/inflammation and fibrosis were compared between three age groups: younger than 18 years, 18-40, and older than 40 years.

<b>RESULTSb>Two hundred eight carriers of the total 219 (95.0%) had histological liver changes. Fifty percent (104/208) of them had mild histological changes (G0-1/S0-1), while more severe changes (G3-4 and/or S3-4) were found in 18 out of the 208. There were no significant differences in the grades of liver necrosis/inflammation and fibrosis between the chronic HBV carriers and the inactive HBsAg carriers. Among the serologic HBV DNA positive carriers, hepatic fibrosis was more severe in the HBeAg negative group than in the positive group (chi2 = 9.551, P = 0.008), but no differences of the necrosis/inflammation grades were seen between the two groups. The rate of severe fibrosis (S3-4) was 21.1% in those carriers older than 40 years but was 7.7% in patients younger than 18 years. However, no statistically significant differences in degrees of liver inflammation and fibrosis were found among the three age groups. HBcAg positive rate was 100% in the liver tissues of all the chronic HBV carriers, but only in 33.3% in the inactive HBsAg carriers.

<b>CONCLUSIONSb>The majority of our HBV carriers have liver inflammation and fibrosis. More severe histological changes were found in 8.65% of them. Liver fibrosis existed in the carriers with negative HBeAg and in those older than 40 years. HBcAg was found in hepatic tissues while their serological HBV DNA was negative.

Adolescent ; Adult ; Carrier State ; pathology ; virology ; Child ; Female ; Hepatitis B Surface Antigens ; blood ; Hepatitis B virus ; Hepatitis B, Chronic ; pathology ; virology ; Humans ; Liver ; pathology ; Male ; Middle Aged ; Young Adult

<b>OBJECTIVEb>In China, liver failure is also termed as severe hepatitis in whom chronic severe hepatitis B (CSHB) is most common. The aim of this study was to assess whether CSHB based on different liver injury extent can meet the international definition of acute-on-chronic liver failure(ACLF)criteria, according by their clinical and pathological feature.

<b>METHODSb>A total of 91 patients with CSHB were involved in the study. The clinical findings, laboratory data and liver pathology features were retrospectively analyzed and grouped by hepatitis virus B carrier state (HBC), chronic hepatitis B (CHB) or liver cirrhosis (LC) before they started liver failure.

<b>RESULTSb>74 out of the 91 patients were male and 17 were female, the mean age was 40.6+/-11.2 years. 9.9%, 7.7% and 82.4% of the patients were based on HBC, CHB and LC respectively. The ages of HBC group were youngest. The mean age of HBC group (years) (25.8+/-6.6) was significantly lower than that of CHB group (36.9+/-9.0) and LC group (42.0+/-10.5)with P values of 0.032 and 0.001 respectively. Most cases presented with sub-acute liver failure characterized by high icterus and ascites. Predisposing factors included exertion, superinfection, virus variation, drugs or alcoholic injury. No difference found between PTA (F = 0.906, P = 0.408) and TBil (F = 0.839, P = 0.436) among the above three groups. The Alb and CHE levels in LC group were (30.3+/-5.1) g/L and (2926.8+/-1471.1) U/L respectively, which were lower than both HBC group [Alb (35.6+/-5.1) g/L, CHE (4363.5+/-2063.2) U/L] and CHB group [Alb (37.4+/-5.0) g/L, CHE (5167.1+/-1522.1) U/L] (F = 9.450; F = 9.297; P value less than 0.01).The level of CHO (1.8+/-1.0) mmol/L in LC group was lower than that of HBC group (2.9+/-1.0mmol/L, P = 0.034), while serum HBV DNA level of HBC group [(6.8+/-1.7) log10copies/ml] was higher than that of LC group [(4.2+/-2.6) log10copies/ml]. The liver tissue in HBC and CHB group showed massive or submassive necrosis which distribute evenly in different parts of liver and similarly in slides, most like acute/subacute severe hepatitis. The chronic lesion was easily covered by extensive necrosis in CSHB based on CHB, with portal fibrosis can be seen by masson stain. Characteristic picture of LC group were massive or submassive necrosis with some nodules were intact or only patchy necrosis of the parenchyma, disparity of extent and stage of necrosis existed in slides, which were the major difference in histopathological change in HBC and CHB group.

<b>CONCLUSIONb>Most of CSHB cases were based on liver cirrhosis, which match with the international definition of ACLF, while small part of CSHB cases based on HBC and CHB are identical to acute/subacute liver failure.

Adult ; Carrier State ; pathology ; virology ; Female ; Hepatitis B, Chronic ; pathology ; Humans ; Liver Cirrhosis ; pathology ; virology ; Liver Failure ; etiology ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Young Adult