Differences in Hematological Characteristics, Including Cholesterol and Apolipoprotein B and E, between Hepatitis B Virus and Hepatitis C Virus Patients in Korea

Hyun Jung Jo; Gyu Nam Park; Hye Ran Kim; Min Ju Kim; Kyung A Shin; Seung Bok Hong; Kyung Soo Chang

doi:10.4167/jbv.2016.46.3.152

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Jo, Park, Kim, Kim, Shin, Hong, and Chang: Differences in Hematological Characteristics, Including Cholesterol and Apolipoprotein B and E, between Hepatitis B Virus and Hepatitis C Virus Patients in Korea

Original Article

J Bacteriol Virol 2016;46(3):152-158.

Published online: 9 February 2016

DOI: https://doi.org/10.4167/jbv.2016.46.3.152

Differences in Hematological Characteristics, Including Cholesterol and Apolipoprotein B and E, between Hepatitis B Virus and Hepatitis C Virus Patients in Korea

Hyun Jung Jo¹, Gyu Nam Park¹, Hye Ran Kim¹, Min Ju Kim¹, Kyung A Shin², Seung Bok Hong³, Kyung Soo Chang^1,

¹Department of Clinical Laboratory Science, Catholic University of Pusan, Busan, Korea

²Department of Clinical Laboratory Science, Shinsung University, Dangjin, Korea

³Department of Clinical Laboratory Science, Chungbuk Health & Science University, Cheongwon, Korea

^∗Corresponding author: Kyung Soo Chang. Department of Clinical Laboratory Science, College of Health Sciences, Catholic University of Pusan, Bugok 3-dong, Geumjeong-gu, Busan 46252, Korea. Phone: +82-51-510-0565, Fax: +82-51-510-0565, e-mail: kschang@cup.ac.kr

^∗∗ This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the ministry of Education, Science and Technology (2012007586) and by Brain Busan 21 (BB21).

Received 27 April 201629 July 2016 Accepted 31 August 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hepatitis B virus (HBV) and hepatitis C virus (HCV) chronically cause hepatitis, liver cirrhosis, and hepatocellular carcinoma, and biomarkers related to liver damage are elevated in HBV and HCV patients. However, comparisons of biomarkers between HBV and HCV patients have not previously been reported. The aim of this study was to investigate differences in hematological biomarker in the sera of HBV and HCV patients and to find a key biomarker to differentiate between HBV and HCV infections. HBV (n=115) and HCV (n=128) samples (serum and whole blood) were collected and tested using a biochemical analysis system. The obtained data were analyzed with SPSS 18.0 statistical software. The mean age of the HCV group (60.3±14.1) was much higher than that of the HBV group (51.1±12.4). Male and female rates were 71.3% and 28.7% in the HBV group and 53.9% and 46.1% in the HCV group, respectively (p = 0.005). AST, ALT, and TG values were higher in the HCV group than in the HBV group. Although γ-GTP and LDL levels were higher in the HBV group than in the HCV group, apoB and apoE levels were much higher in HCV group than in HBV group (p < 0.001). There were no significant differences in the other hematological biomarkers between the HBV and HCV groups. In conclusion, HBV rates were higher in male patients, and HCV rates were higher in older patients. In particular, apoE and apoB were more highly expressed in HCV patients, and they might be key markers to differentiate HCV infection.

Keywords: Hepatitis B virus, Hepatitis C virus, Hematological biomarker, Apolipoprotein B & E

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Figure 1.

Distribution of HBV and HCV patients according to age.

Table 1.

Comparison of age and gender between HBV and HCV patients

Characteristics	HBV (n=115)	HCV (n=128)	p
Age (mean ± SD)	51.1±12.4	60.3±14.1	0.000^a
Gender (n, %)
Male	82 (71.3)	69 (53.9)	0.005^b
Female	33 (28.7)	59 (46.1)

^a Analyses of Student's t-test

^b Analyses of cross-tabulation test

Table 2.

Comparison of hematological characteristics between HBV and HCV patients

Characteristics (unit)	HBV	HCV	Control	p^a	p^b	p^c
AFP (ng/ml)	94.7±597.8	79.1±406.9	2±1.1	0.790	0.745	0.843
Total protein (g/dl)	7.2±0.7	7.4±0.7	6.8±1.6	0.411	0.125	0.012
Albumin (g/dl)	4.0±0.5	4.0±0.6	4.4±0.1	0.353	0.352	0.862
AST (IU/l)	50.3±75.8	59.4±65.6	21.4±4.6	0.233	0.070	0.317
ALT (IU/l)	42.3±65.9	48.6±51.6	16.5±3.6	0.220	0.052	0.406
Total bilirubin (mg/dl)	1.7±4.2	1.1±1.6	0.8±0.3	0.688	0.802	0.110
ALP (IU/l)	301.9±256.5	303.1±216.0	242.5±46.3	0.646	0.578	0.971
γ-GTP (IU/l)	89.9±167.4	77.5±125.8	19.2±6.4	0.187	0.148	0.551
BUN (mg/dl)	17.2±9.5	19.4±14.9	16.2±3.6	0.840	0.670	0.183
Creatinine (mg/dl)	1.325±1.6	1.329±1.2	0.954±0.1	0.465	0.326	0.982
TG (mg/dl)	112.9±69.7	122.4±8.8	112±66.9	0.970	0.720	0.444
Total cholesterol (mg/dl)	163.9±37.4	164.7±43.6	224.3±32.0	0.000	0.000	0.876
HDL (mg/dl)	48.8±15.1	48.3±14.0	74.8±27.2	0.000	0.000	0.867
LDL (mg/dl)	107.8±32.5	102.7±29.5	135.2±43.8	0.032	0.004	0.415
ApoB (µg/µl)	4.2±3.1	7.7±13.1	1.9±1.3	0.022	0.167	0.004
ApoE (µg/µl)	0.113±0.080	0.214±0.171	0.058±0.016	0.032	0.000	0.000

AFP, α-fetoprotein; AST, aspartate aminotransferase; ALT, alanine aminotransferase; ALP, alkaline phosphatase; γ-GTP, γ-glutamyl transferase; BUN, TG, triglyceride; HDL, high density lipoprotein; LDL, low density lipoprotein; ApoB, apolipoprotein B; ApoE, apolipoprotein E.

^a comparison between HBV patients and normal controls

^b comparison between HCV patients and normal controls

^c comparison between HBV and HCV patients

Table 3.

Comparison of apolipoprotein E genotype between HBV and HCV patients

							n (%)
Hepatitis virus	Apolipoprotein E genotype						Total
Hepatitis virus	ε2/ε2	ε2/ε3	ε2/ε4	ε3/ε3	ε3/ε4	ε4/ε4	Total
HBV	0 (0)	15 (13.0)	4 (3.5)	83 (72.2)	13 (11.3)	0 (0)	115 (100)
HCV	0 (0)	13 (10.2)	1 (0.8)	101 (78.9)	13 (10.2)	0 (0)	128 (100)

Table 4.

Comparison of apolipoprotein E gene allele between HBV and HCV patients

n (%)
Hepatitis virus	ApoE allele			Total
Hepatitis virus	ε2	ε3	ε4	Total
HBV	19 (8.3)	194 (84.3)	17 (7.4)	230 (100)
HCV	14 (5.5)	228 (89.1)	14 (5.5)	256 (100)

Table 5.

Comparison of hematological characteristics between HBV and HCV patients by apoE genotype

Characteristics	Hepatitis virus	ε2/ε3	ε2/ε4	ε3/ε3	ε3/ε4
n	HBV	15	4	83	13
n	HCV	13	1	101	13
AFP (ng/ml)	HBV	65.6±83.5	3.5±1.4	95.3±572.0	4.6±4.4
AFP (ng/ml)	HCV	76.6±197.3	3.8	73.3±444.9	124.4±305.1
Total protein (g/dl)	HBV	7.3±1.0	7.0±0.5	7.3±0.9	7.0±0.8
Total protein (g/dl)	HCV	7.5±0.9	6.7	7.4±0.7	7.3±0.8
Albumin (g/dl)	HBV	3.9±0.6	4.1±0.2	4.0±0.6	4.1±0.5
Albumin (g/dl)	HCV	4.0±0.7	3.8	4.0±0.6	3.9±0.5
AST (IU/l)	HBV	71.9±143.6	19.8±5.7	55.0±67.1	43.2±50.6
AST (IU/l)	HCV	62.5±40.6	19.0	61.2±70.8	44.7±41.2
ALT (IU/l)	HBV	66.9±148.3	21.8±6.1	45.3±50.2	29.4±22.4
ALT (IU/l)	HCV	55.8±50.5	33.0	50.3±54.7	29.7±15.4
Total bilirubin (mg/dl)	HBV	2.1±8.2	0.8±0.1	1.2±2.2	2.9±5.9
Total bilirubin (mg/dl)	HCV	0.9±0.4	1.0	1.1±1.8	1.0±0.6
ALP (IU/l)	HBV	293.1±148.3	218.5±27.6	312.9±259.1	211.5±86.5
ALP (IU/l)	HCV	302.3±146.4	188.0	304.7±234.8	301.1±126.2
γ-GTP (IU/l)	HBV	72.6±71.6	31.0±2.8	86.3±148.0	30.2±16.2
γ-GTP (IU/l)	HCV	93.8±81.2	23.0	67.6±97.2	53.3±288.5
BUN (mg/dl)	HBV	21.5±11.5	14.5±1.8	18.1±11.1	15.7±10.7
BUN (mg/dl)	HCV	23.5±28.3	17.6	18.8±12.3	20.3±15.8
Creatinine (mg/dl)	HBV	1.2±0.8	1.1±0.2	1.3±1.5	1.1±0.2
Creatinine (mg/dl)	HCV	1.2±0.6	0.9	1.3±1.1	1.7±2.4
Total cholesterol (mg/dl	l) HBV	157.0±43.7	156.0±6.4	166.0±43.6	161.9±34.8
Total cholesterol (mg/dl	l) HCV	155.8±28.6	214.0	165.8±46.5	161.1±32.3
TG (mg/dl)	HBV	128.1±90.0	75.0±22.6	119.4±84.5	103.0±43.8
TG (mg/dl)	HCV	116.8±70.2	92.0	125.9±96.0	106.1±40.8
HDL (mg/dl)	HBV	45.8±14.6	35.0	48.3±15.0	51.4±19.5
HDL (mg/dl)	HCV	44.3±12.6	ㅡ	48.1±14.8	54.3±6.5
LDL (mg/dl)	HBV	95.1±40.2	85.0	105.7±32.8	105.7±13.1
LDL (mg/dl)	HCV	88.4±36.3	ㅡ	104.0±29.7	110.6±12.6
ApoB (µg/µl)	HBV	4.822±4.0	3.290±1.9	6.452±11.0	3.622±1.9
ApoB (µg/µl)	HCV	5.182±6.6	1.627±0.004	8.244±14.4	6.715±6.7
ApoE (µg/µl)	HBV HCV	0.177±0.094 0.200±0.119	0.066 0.126	0.174±0.152 0.222±0.179	0.063±0.040 0.179±0.155

AFP, α-fetoprotein; AST, aspartate aminotransferase; ALT, alanine aminotransferase; ALP, phopho; γ-GTP, γ-glutamyl transferase; BUN, TG, triglyceride; HDL, high density lipo; LDL, low density; ApoB, apolipoprotein B; ApoE, apolipoprotein E.

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