Quantitative hepatitis B core antibody level is associated with inflammatory activity in treatment-naïve chronic hepatitis B patients

Abstract

Previous studies have shown that hepatitis B core antibody (anti-HBc) levels vary during different phases of disease in treatment-naïve chronic hepatitis B (CHB) patients and can be used as a predictor of both interferon-α and nucleoside analogue therapy response. However, there is no information on the association between the quantitative serum anti-HBc (qAnti-HBc) level and liver inflammation in CHB patients. Therefore, we investigated these relationships in a large cohort of treatment-naïve CHB patients. A total of 624 treatment-naïve CHB patients were included in the study. The serum qAnti-HBc level was moderately correlated with ALT and AST levels (P < 0.001) in both hepatitis B e antigen-positive (HBeAg [+]) and HBeAg-negative (HBeAg [−]) CHB patients. CHB patients with no to mild inflammation (G0–1) had significantly lower serum qAnti-HBc levels than patients with moderate to severe inflammation (G2–4) (P < 0.001). Receiver operating characteristic analysis suggested that a serum qAnti-HBc cut-off value of 4.36 log10 IU/mL provided a sensitivity of 71.68%, specificity of 73.81%, positive predictive value of 78.43%, and negative predictive value of 66.24% in HBeAg (+) CHB patients with moderate to severe inflammation (G≥2). A cut-off value of 4.62 log10 IU/mL provided a sensitivity of 54.29%, specificity of 90.00%, positive predictive value of 95.00%, and negative predictive value of 36.00% in HBeAg (−) CHB patients with moderate to severe inflammation (G≥2). Serum qAnti-HBc levels were positively associated with liver inflammation grade. Furthermore, we identified optimal serum qAnti-HBc cut-off values for the prediction of inflammation activity in both HBeAg (+) and HBeAg (−) treatment-naïve CHB patients.

Role of quantitative hepatitis B core antibody levels in predicting significant liver inflammation in chronic hepatitis B patients with normal or near‐normal alanine aminotransferase levels

“…Moreover, the qAnti‐HBc level varies greatly at different phases of HBV infection . The qAnti‐HBc level was also reported to be significantly correlated with liver inflammation grade in treatment‐naïve CHB patients . At present, there is a lack data about the utility of qAnti‐HBc levels for diagnosis of significant inflammation in patients with normal or near‐normal ALT levels.…”

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

“…Previous studies have shown that serum HBsAg of HBeAg-positive patients and serum HBV DNA of HBeAgnegative patients are valuable but not very satisfactory in predicting liver inflammation intensities and fibrosis levels [31][32][33][34][35][36]. Lately, preliminary studies have demonstrated that anti-HBc may be useful in predicting liver inflammation intensities and fibrosis levels [15][16][17][18][19][20]. is study indicated that the AUC of anti-HBc of HBeAg-positive patients in predicting pathological grades ≥G2 and ≥G3 was both close to that of serum HBsAg and both significantly greater than that of serum HBV DNA, and in predicting pathological stages ≥S2 and �S4 was both close to that of serum HBsAg and, respectively, significantly greater than and close to that of serum HBV DNA.…”

“…Recently, some studies have explored the predictive value of anti-HBc for liver pathological states in patients with chronic HBV infection from a practical perspective, but the performance of this has not been investigated in detail [15][16][17][18][19][20]. To further characterize the theoretical and practical value of anti-HBc, we comparatively depicted the evolving patterns of anti-HBc versus serum HBsAg and HBV DNA following liver inflammation intensities and fibrosis levels and evaluated the performance of anti-HBc versus serum HBsAg and HBV DNA in predicting liver inflammation intensities and fibrosis levels in patients with chronic HBV infection.…”

Evaluation of impact of occult hepatitis B infection in chronic HCV-infected patients: A retrospective cohort study

“…Positive correlation between qAnti-HBc, transaminase levels and liver inflammation has been hypothesized by several authors. [ 24 25 26 ] Predictive value of pretreatment quantification of qAnti-HBc levels for the treatment response in CHB patients on Peg-IFN therapy has also been studied by Hou et al . [ 27 ] While the exact underlying mechanism of the positive correlation between serum qAnti-HBc level, serum alanine aminotransferase (ALT) level and inflammation severity remains to be examined, a possible mechanistic explanation for this association is that all of these features are determined by the host's immune responses.…”