Background/aims: In chronic hepatitis B, hepatic progenitor cells (HPCs) activation and ductular reactions occurred in periportal and portal area. However, the association between hepatitis B virus (HBV) infection and HPCs activation remains unknown. We aim to investigate the expansion of HPCs in patients with end-stage chronic hepatitis B and its relationship to HBV infection.
Methodology: Liver biopsy specimens from 16 cases of end-stage liver disease caused by chronic hepatitis B were studied. The quantities of serum HBV DNA were available in 13 patients. The number of HPCs and the area of ductular reactions were quantitively analyzed on the cytokeratin 7 (CK7)-stained sections. Double-staining combined either HBsAg or HBcAg with CK7 were performed to assess the histological relationship between HBV infection and HPCs activation.
Results: All of the sections showed liver cirrhosis and severe inflammation (HAI ranged from 12 to 17). The number of HPCs correlated with the area of ductular reactions positively. Multivariate analysis showed that serum HBV DNA level was independently associated with HPCs activation and ductular reactions. Moreover, the expression area of HBsAg in liver tissue correlated with HPCs activation positively.
Conclusions: In end-stage of chronic hepatitis B, the expansion of hepatic progenitor cells and ductular reactions were extensive. HBV infection may be involved in the proliferation of progenitor cells in cirrhotic environments.