Quantitative Anti-HBc in Liver Pathological States in Patients with Chronic Hepatitis B Virus Infection

Abstract

Background. Changes of hepatitis B core antigen antibody (anti-HBc) in liver pathological involvement in patients with chronic hepatitis B virus (HBV) infection have not been investigated in detail. This study aimed to explore evolving patterns of anti-HBc following liver pathological states and to investigate validities of anti-HBc for predicting liver pathological states. Methods. 254 HBeAg-positive and 237 HBeAg-negative patients with chronic HBV infection were enrolled. Liver pathological diagnoses referred to Scheuer standard, and anti-HBc was measured using chemiluminescence microparticle immunoassay. Results. Anti-HBc was significantly positively correlated with pathological grades and stages in both HBeAg-positive (rs = 0.312, P<0.0001, and rs = 0.268, P<0.0001) and HBeAg-negative (rs = 0.270, P<0.0001, and rs = 0.147, P=0.0237) patients. The medians of anti-HBc in pathological grades of G1, G2, and G3 and stages of S1, S2, S3, and S4 in HBeAg-positive patients were all significantly lower than those in HBeAg-negative patients (all P<0.005). The areas under receiver-operating characteristic curves (95% confidence interval) of anti-HBc for predicting pathological grades ≥G2 and ≥G3, and stages ≥S2 and =S4 in HBeAg-positive patients were 0.683 (0.622–0.740) and 0.662 (0.601–0.720), and 0.627 (0.564–0.687) and 0.683 (0.622–0.740), respectively, and in HBeAg-negative patients were 0.681 (0.618–0.740) and 0.702 (0.639–0.760), and 0.569 (0.503–0.633) and 0.630 (0.565–0.691), respectively. Conclusion. Following hepatic aggravation of necroinflammation and progression of fibrosis, anti-HBc increases gradually in HBeAg-positive patients and continues to increase gradually in HBeAg-negative patients, which is a useful but unsatisfactory marker for monitoring pathological states.

Quantitative HBsAg versus HBV DNA in Predicting Significant Hepatitis Activity of HBeAg-Positive Chronic HBV Infection

“…Nevertheless, HBsAg in patients with HBeAg-positive chronic HBV infection was significantly positively correlated with HBV DNA [ 13 , 14 , 21 ]. In addition, the high levels of HBsAg associated with high other than medium or low HBV replication may contuse the host’s immune responses against HBV, which may be the direct key factor leading to non-significant hepatitis activity in patients with HBeAg-positive chronic HBV infection [ 15 , 22 ]. Therefore, the studies, whether by referring to the conventional phasing criteria of natural history that covers HBVDNA intrinsically related to the production of HBsAgor based on the overall population of HBeAg-positive stage that covers the subpopulation with low HBV replication, could not accurately obtain valuable information reflecting the performance of HBsAg in the prediction of HBeAg-positive significant hepatitis activity activity (See Appendix A.3 , Appendix A.4 , Appendix A.5 , Appendix A.6 , Appendix A.7 and Appendix A.8 ).…”

Durability of Antibody Response Against Hepatitis B Virus for a Decreased Crowd: A Retrospective Polycentric Cohort Study from a 10-Year Follow-Up Clinical Study

“…Anti-Hbc(+) patients were rather common in the census. [21][22][23][24] However, the anti-Hbc(+) groups in the control groups and case groups have rarely been reported. Presently, the retrospective polycentric cohort study suggested that the median HBsAb level of Group 4 was lower than that of the other groups and that its median was 50.8 mlU/mL.…”

Serum qAnti‐HBc combined with ALT and HBsAg predicts significant hepatic inflammation in HBeAg‐positive immune active patients

“…14 Recently, quantitative anti-HBc (qAnti-HBc) was reported to predict HBeAg seroconversion in HBeAg-positive patients with peg-interferon or nucleos(t)ide analogs (NUCs) treatment, and with varying levels in different phases of CHB patients. [15][16][17] Positive correlations of qAnti-HBc with liver inflammation and fibrosis grades in both HBeAg (+) and HBeAg (À) treatment naïve CHB patients were also reported. [18][19][20] Moreover, qAnti-HBc could also predict liver inflammation, and its combination with ALT was more reliable in predicting significant liver inflammation in CHB patients with normal or near-normal ALT levels.…”

“…It can help judge the prognosis of CHB patients 14 . Recently, quantitative anti‐HBc (qAnti‐HBc) was reported to predict HBeAg seroconversion in HBeAg‐positive patients with peg‐interferon or nucleos(t)ide analogs (NUCs) treatment, and with varying levels in different phases of CHB patients 15–17 . Positive correlations of qAnti‐HBc with liver inflammation and fibrosis grades in both HBeAg (+) and HBeAg (−) treatment naïve CHB patients were also reported 18–20 .…”