Ye Y, Zhang Q, Lu ZH, Tan YW. Clinicopathological features of 11 cases of chronic hepatitis B infection complicated with primary biliary cholangitis. World J Hepatol 2023; 15(4): 577-584 [PMID: 37206657 DOI: 10.4254/wjh.v15.i4.577]
Corresponding Author of This Article
You-Wen Tan, MD, Chief Doctor, Professor, Department of Hepatology, The Third Hospital of Zhenjiang Affiliated Jiangsu University, No. 300 Daijiamen, Runzhou Distinct, Zhenjiang 212003, Jiangsu Province, China. tyw915@sina.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Apr 27, 2023; 15(4): 577-584 Published online Apr 27, 2023. doi: 10.4254/wjh.v15.i4.577
Clinicopathological features of 11 cases of chronic hepatitis B infection complicated with primary biliary cholangitis
Yun Ye, Qian Zhang, Zhong-Hua Lu, You-Wen Tan
Yun Ye, Qian Zhang, You-Wen Tan, Department of Hepatology, The Third Hospital of Zhenjiang Affiliated Jiangsu University, Zhenjiang 212003, Jiangsu Province, China
Zhong-Hua Lu, Department of Liver Disease, Wuxi No. 5 People’s Hospital Affiliated to Jiangnan University, Wuxi 214000, Jiangsu Province, China
Author contributions: Ye Y, Zhang Q, and Lu ZH contributed equally to the research; Tan YW and Ye Y designed the research; Zhang Q and Lu ZH collected and analyzed the data and drafted the manuscript; Tan YW performed the liver pathological evaluations; Tan YW and Ye Y wrote and revised the manuscript; all authors read and approved the final version for publication.
Supported bythe Social Development Project of Jiangsu Province, No. BE2020775; and Chinese Federation of Public Health Foundation, No. GWLM202002.
Institutional review board statement: The study was reviewed and approved by the Medical Ethics Committee of the Third Hospital of Zhenjiang Affiliated Jiangsu University (No. 202238).
Informed consent statement: Informed consent for liver biopsy and treatments were obtained from the patients.
Conflict-of-interest statement: The authors have no conflict of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: You-Wen Tan, MD, Chief Doctor, Professor, Department of Hepatology, The Third Hospital of Zhenjiang Affiliated Jiangsu University, No. 300 Daijiamen, Runzhou Distinct, Zhenjiang 212003, Jiangsu Province, China. tyw915@sina.com
Received: January 24, 2023 Peer-review started: January 24, 2023 First decision: March 6, 2023 Revised: March 9, 2023 Accepted: March 29, 2023 Article in press: March 29, 2023 Published online: April 27, 2023 Processing time: 86 Days and 0 Hours
Abstract
BACKGROUND
Only a few cases of chronic hepatitis B (CHB) with primary biliary cholangitis (PBC) have been reported based on histological evidence from liver biopsies.
AIM
To observe the clinicopathological features and outcomes of 11 patients with CHB infection complicated by PBC.
METHODS
Eleven patients with CHB and PBC who underwent liver biopsy at the Zhenjiang Third Hospital, affiliated with Jiangsu University, and Wuxi Fifth People’s Hospital, from January 2005 to September 2020, were selected. All patients initially visited our hospital with CHB and were pathologically diagnosed with CHB and PBC.
RESULTS
Only five had elevated alkaline phosphatase levels, nine were positive for anti-mitochondrial antibody (AMA)-M2, and two were negative for AMA-M2. Two had jaundice and pruritus symptoms, 10 had mildly abnormal liver function, and one had severely elevated bilirubin and liver enzyme levels. The pathological characteristics of CHB complicated by PBC overlapped with those of PBC-autoimmune hepatitis (AIH). When necroinflammation of the portal area is not obvious, the pathological features of PBC are predominant, similar to the features of PBC alone. When the interface is severe, biliangitis will occur, with a large number of ductular reactions in zone 3. Unlike the PBC-AIH overlap pathology, this pathology is characterized by a small amount of plasma cell infiltration. Unlike PBC, lobulitis is often observed.
CONCLUSION
This is the first large case series to show that the rare pathological features of CHB with PBC are similar to those of PBC-AIH and small duct injury was observed.
Core Tip: We retrospectively observed the clinicopathological features and outcomes of 11 patients with chronic hepatitis B (CHB) infection complicated by primary biliary cholangitis (PBC). We found that CHB complicated with PBC had pathological characteristics overlapping with PBC-autoimmune hepatitis. When necroinflammation of the portal area is not obvious, the pathological features of PBC are superior, similar to the features of PBC alone, this pathology is characterized by a small amount of plasma cell infiltration. Unlike PBC alone, lobulitis is often present. All patients improved after antiviral and ursodeoxycholic acid treatment and stabilized after 1 year.
