Correlation of serum hepatitis B core-related antigen with hepatitis B virus total intrahepatic DNA and covalently closed circular-DNA viral load in HIV–hepatitis B coinfection

Lorenza N.C. Dezanet, Sarah Maylin, Audrey Gabassi, Hayette Rougier, Patrick Miailhes, Caroline Lascoux-Combe, Julie Chas, Pierre Marie Girard, Constance Delaugerre, Fabien Zoulim, Karine Lacombe, Anders Boyd

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Abstract

Objective: To assess whether quantified hepatitis B core-related antigen (qHBcrAg) is a surrogate marker of intrahepatic replication in HIV and hepatitis B virus (HBV) coinfection. Design: Cross-sectional study of 31 HIV – HBV-infected patients (total liver biopsies, n ¼ 38) from a well defined cohort. Methods: Spearman’s rank correlation coefficients were calculated between qHBcrAg and intrahepatic markers of HBV replication [total intrahepatic-DNA, covalently closed circular (ccc) DNA, cccDNA: total intrahepatic-DNA ratio]. Results: At biopsy, 22 (71.0%) patients were hepatitis B ‘e’ antigen (HBeAg)-positive, 22 (71.0%) had detectable plasma HBV-DNA, and 17 (54.8%) were treated with tenofovir. Median levels (interquartile range) of intrahepatic markers were as follows: HBV cccDNA (n ¼ 34), 0.26 copies/cell (0.4 – 2.89); total intrahepatic-DNA (n ¼ 38), 2.38 copies/cell (0.58 – 207.9), and cccDNA: total intrahepatic-DNA ratio (n ¼ 34), 0.05 (interquartile range ¼ 0.01 – 0.12). There was a significantly strong correlation between qHBcrAg and cccDNA in all patients (Rho ¼ 0.65, P < 0.001), while a moderate correlation was observed between qHBcrAg and total intrahepatic-DNA (Rho ¼ 0.57, P < 0.001) or cccDNA: total intrahepatic-DNA ratio (Rho ¼ -0.45, P ¼ 0.01). Similar findings were observed for HBeAg-positive patients and those with detectable HBV-DNA, with the exception of qHBcrAg and cccDNA or cccDNA: total intrahepatic-DNA ratio. In contrast, no significant correlation between qHBcrAg and any intrahepatic marker was observed in HBeAg-negative patients or those with undetectable HBV-DNA. No significant difference was observed in median qHBcrAg levels across liver fibrosis stages (P ¼ 0.5). Conclusion: qHBcrAg is a potential surrogate marker of cccDNA in HIV–HBV coinfected patients, yet might be less useful with undetectable serum HBV-DNA or HBeAg-negative status. Whether qHBcrAg provides further clinical utility compared with other serological markers remains debatable.

Original languageEnglish
Pages (from-to)1943-1949
Number of pages7
JournalAIDS
Volume34
Issue number13
DOIs
Publication statusPublished - 1 Nov 2020
Externally publishedYes

Keywords

  • Biomarker
  • Covalently closed circular DNA
  • HIV
  • Hepatitis B core-related antigen
  • Hepatitis B virus
  • Intrahepatic DNA

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