Caviglia Gian Paolo, Armandi Angelo, Rosso Chiara, Ribaldone Davide Giuseppe, Pellicano Rinaldo, Fagoonee Sharmila
Department of Medical Sciences, University of Turin, 10124 Turin, Italy.
Unit of Gastroenterology, Città della Salute e della Scienza di Torino-Molinette Hospital, 10126 Turin, Italy.
Diagnostics (Basel). 2021 Jan 28;11(2):187. doi: 10.3390/diagnostics11020187.
Hepatitis B virus (HBV) covalently-closed-circular (ccc)DNA is the key molecule responsible for viral persistence within infected hepatocytes. The evaluation of HBV cccDNA is crucial for the management of patients with chronic HBV infection and for the personalization of treatment. However, the need for liver biopsy is the principal obstacle for the assessment of intrahepatic HBV cccDNA. In the last decade, several studies have investigated the performance of hepatitis B core-related antigen (HBcrAg) as a surrogate of HBV cccDNA amount in the liver. In this meta-analysis, we collected 14 studies (1271 patients) investigating the correlation between serum HBcrAg and intrahepatic HBV cccDNA. Serum HBcrAg showed a high correlation with intrahepatic HBV cccDNA ( = 0.641, 95% confidence interval (CI) 0.510-0.743, < 0.001). In a head-to-head comparison, we observed that the performance of HBcrAg was significantly superior to that of hepatitis B surface antigen ( = 0.665 vs. = 0.475, respectively, < 0.001). Subgroup analysis showed that the correlation between HBcrAg and intrahepatic HBV cccDNA was high, both in hepatitis B e antigen-positive and -negative patients ( = 0.678, 95% CI 0.403-0.840, < 0.001, and = 0.578, 95% CI 0.344-0.744, < 0.001, respectively). In conclusion, the measurement of serum HBcrAg qualifies as a reliable non-invasive surrogate for the assessment of an intrahepatic HBV cccDNA reservoir.
乙型肝炎病毒（HBV）共价闭合环状（ccc）DNA是导致病毒在受感染肝细胞内持续存在的关键分子。评估HBV cccDNA对于慢性HBV感染患者的管理和治疗个体化至关重要。然而，需要进行肝活检是评估肝内HBV cccDNA的主要障碍。在过去十年中，多项研究调查了乙型肝炎核心相关抗原（HBcrAg）作为肝脏中HBV cccDNA量替代指标的性能。在这项荟萃分析中，我们收集了14项研究（1271例患者），调查血清HBcrAg与肝内HBV cccDNA之间的相关性。血清HBcrAg与肝内HBV cccDNA显示出高度相关性（ = 0.641，95%置信区间（CI）0.510 - 0.743， < 0.001）。在直接比较中，我们观察到HBcrAg的性能显著优于乙型肝炎表面抗原（分别为 = 0.665对 = 0.475， < 0.001）。亚组分析表明，在乙型肝炎e抗原阳性和阴性患者中，HBcrAg与肝内HBV cccDNA之间的相关性都很高（分别为 = 0.678，95% CI 0.403 - 0.840， < 0.001，以及 = 0.578，95% CI 0.344 - 0.744， < 0.001）。总之，血清HBcrAg的检测可作为评估肝内HBV cccDNA储存库的可靠非侵入性替代指标。
