Hepatitis B Virus Load in Serum Does Not Reflect Histologic Activity in Patients With Decompensated Cirrhosis  Jin Dong Kim, Jong Young Choi, Si Hyun.

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Hepatitis B Virus Load in Serum Does Not Reflect Histologic Activity in Patients With Decompensated Cirrhosis  Jin Dong Kim, Jong Young Choi, Si Hyun Bae, Seung Kew Yoon, Jin Mo Yang, Nam Ik Han, Sang Wook Choi, Chang Don Lee, Young Sok Lee, Eun Sun Jung  Clinical Gastroenterology and Hepatology  Volume 8, Issue 1, Pages 60-65 (January 2010) DOI: 10.1016/j.cgh.2009.09.026 Copyright © 2010 AGA Institute Terms and Conditions

Figure 1 Patient enrollment protocol. aclf, acute-on-chronic liver failure; alf, acute liver failure; hcc, hepatocellular carcinoma; hcv, hepatitis C virus; sbp, spontaneous bacterial peritonitis. Clinical Gastroenterology and Hepatology 2010 8, 60-65DOI: (10.1016/j.cgh.2009.09.026) Copyright © 2010 AGA Institute Terms and Conditions

Figure 2 Serum HBV DNA levels according to (A) lobular and (B) portoperiportal activity. The medians are depicted as lines within boxes, the 25th and 75th percentiles are depicted as the lines at the lower and upper ends of the boxes, respectively, and the 5th and 95th percentiles are depicted as the lower and upper whisker bars, respectively. There were no differences in HBV DNA level between patients grouped according to lobular or portoperiportal necroinflammatory activity (P = .678, P = .291, respectively). Clinical Gastroenterology and Hepatology 2010 8, 60-65DOI: (10.1016/j.cgh.2009.09.026) Copyright © 2010 AGA Institute Terms and Conditions

Figure 3 Portoperiportal activity according to HBV DNA level. Of 16 patients with HBV DNA levels less than 2000 copies/mL, 8 patients (50.0%) had moderate (grade 3) or severe (grade 4) portoperiportal necroinflammatory activity. Clinical Gastroenterology and Hepatology 2010 8, 60-65DOI: (10.1016/j.cgh.2009.09.026) Copyright © 2010 AGA Institute Terms and Conditions

Figure 4 Histologic findings on decompensated cirrhosis with HBV DNA negativity. Although the 36-year-old man from whom this liver explant was obtained was negative for HBV DNA (<28 copies/mL) and had a normal ALT level (28 U/L), he had (A) grade 3 lobular activity (H&E stain: original magnification, 40×) and (B) grade 4 portoperiportal activity (H&E stain: original magnification, 40×). Of the same patient, many hepatocytes showed positive cytoplasmic staining for (C) HBsAg, and both cytoplasmic and nuclear positivity was seen in the immunohistochemical staining for (D) hepatitis B core antigen. Clinical Gastroenterology and Hepatology 2010 8, 60-65DOI: (10.1016/j.cgh.2009.09.026) Copyright © 2010 AGA Institute Terms and Conditions

Figure 5 Serum ALT levels according to HBV DNA level. Clinical Gastroenterology and Hepatology 2010 8, 60-65DOI: (10.1016/j.cgh.2009.09.026) Copyright © 2010 AGA Institute Terms and Conditions