Serum hepatitis B core antibody titer use in screening for significant fibrosis in treatment-naïve patients with chronic hepatitis B

Abstract

BackgroundPrevious studies have revealed that hepatitis B core antibody (anti-HBc) levels vary throughout the different phases of treatment-naïve chronic hepatitis B (CHB) patients and can be used as a predictor of treatment response in both interferon-α and nucleoside analogue therapies. However, few data have been published regarding the relationship between quantitative anti-HBc (qAnti-HBc) levels and liver fibrosis in patients with CHB.ResultsA total of 489 HBeAg-positive (HBeAg (+)) and 135 HBeAg-negative (HBeAg (−)) patients were recruited. In both HBeAg (+) and HBeAg (−) groups, the S0−1/S0 subjects had significantly lower qAnti-HBc levels than the S2−4 subjects (p < 0.05). Multiple logistic regression analysis showed that the parameters for predicting significant fibrosis (S ≥ 2) included age, PLT and qAnti-HBc. In HBeAg (+) subjects, the AUROC of qAnti-HBc for predicting significant fibrosis was 0.734 (95% CI 0.689 to 0.778) and the optimal cut-off was 4.58 log10IU/mL, with a sensitivity of 63.08% and a specificity of 74.83%. In HBeAg (−) subjects, the AUROC was 0.707 (95% CI 0.612 to 0.801) and the optimal cut-off value was 4.37 log10IU/mL, with a sensitivity of 75.53% and a specificity of 56.10%.Materials and MethodsFrom 2012 to 2015, we conducted a cross-sectional study of treatment-naïve CHB patients. Liver biochemistry, hepatitis B virus (HBV) serological markers, HBV DNA, hepatitis B surface antigen (HBsAg) titers and HBV genotype were determined using commercial assays, and serum qAnti-HBc levels were measured using double-sandwich immunoassay. Liver biopsies and serum samples were obtained on the same day.ConclusionsThe present study showed an association between high serum qAnti-HBc levels and significant fibrosis (S ≥ 2) in treatment-naïve CHB patients. Furthermore, we described a serum qAnti-HBc cut-off for predicting significant fibrosis in CHB patients infected with HBV genotype B or C.

Association of Hepatitis B Core-Related Antigen and Antihepatitis B Core Antibody With Liver Fibrosis Evolution in Human Immunodeficiency Virus-Hepatitis B Virus Coinfected Patients During Treatment With Tenofovir

“…We were unable to confirm previous studies in HBV-monoinfected patients in which positive associations between single-measured qHBcrAg or qAnti-HBc levels and liver fibrosis were observed [ 17 , 18 , 29–31 ]. This includes 1 study that found an association with qHBcrAg levels and development of liver fibrosis, as defined by the noninvasive marker of liver fibrosis FIB-4 [ 29 ].…”

“…A flurry of research on new surrogate markers of hepatitis B, including quantification of hepatitis B core-related antigen (qHBcrAg) and quantification of antihepatitis B core antibody (qAnti-HBc), has suggested a role for their use in monitoring HBV-related liver fibrosis [ 16 , 17 ]. Quantification of hepatitis B core-related antigen, an antigen consisting of proteins sharing an identical 149 amino acid sequence (including hepatitis B core antigen, HBeAg, and a truncated 22-kDa “precore” protein), is particularly interesting because of its strong correlation with liver fibrosis, as assessed via liver biopsies [ 18 ].…”

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.…”

Europium (III) chelate microparticle-based lateral flow immunoassay strips for rapid and quantitative detection of antibody to hepatitis B core antigen

“…Anti-HBc is one of the most classical serological markers during HBV infection and has been widely used in clinical diagnosis or blood screening 4 . More importantly, qAnti-HBc measurements could play an important role in evaluating the therapy and optimising the antiviral therapy of CHB 8 – 13 , 28 . However, there are only a few methods to quantitatively analyze anti-HBc level in human serum, and these methods require expensive instrumentation, complexity of the procedures, and long operation times.…”