Hepatitis B core antigen expression in hepatocytes reflects viral response to Peg-IFNα-2a in HBeAg-positive chronic hepatitis B patients

Hepatitis B core antigen is known to be a major target for virus-specific T cells and also reflects the progression of liver disease and viral replication. This study aims to evaluate whether topographical distribution of hepatitis B core antigen expres-sion can predict viral response to Peginterferon alfa-2a (Peg-IFN alpha-2a) in patients with chronic hepatitis B. We enrolled 207 patients with chronic hepatitis B. All patients underwent liver biopsy, and the existence and pattern of hepatitis B core antigen evaluated by immunohistochemistry. All patients received 180 mu g of Peg-IFN alpha-2a once weekly for 48 weeks following a liver biopsy. We checked viral response at 48 weeks during antiviral therapy. Of 207 patients, 11 (5.31%) had no hepatitis B core antigen expression (HBcAg-negative), others had hepatitis B core antigen expression. Of the hepatitis B core antigen expression, 83 (42.35%) belong to cytoplasmic expression (cHBcAg), 105 (53.57%) cases was cytoplasmic dominance expression (cdHBcAg), while only 8 (4.08%) belong to cytoplasmic and nuclear mean expression (mHBcAg). HBcAg-negative group has lowest baseline HBV DNA among four groups (P<0.01). Liver tissue inflammation in HBcAg-negative group and cHBcAg group reached G3 (respectively 54.55%, 42.17%), and were higher than other groups (P<0.01). The viral response was significantly higher in HBcAg-negative group than in hepatitis B core antigen-positive group (88.9% and 54.7%, respectively; P<0.001) after 48 weeks of Peg-IFN alpha therapy. In conclusion, chronic hepatitis B patients who are hepatitis B core antigen-negative have a better response to Peg-IFN alpha therapy than do hepatitis B core antigen-positive patients.