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

Oncotarget. 2017 Feb 14;8(7):11063-11070. doi: 10.18632/oncotarget.14323.

Abstract

Background: Previous 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.

Results: A 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 methods: From 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.

Conclusions: The 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.

Keywords: chronic hepatitis B; diagnostics; liver fibrosis; quantitative anti-HBc.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Female
  • Genotype
  • Hepatitis B Antibodies / blood
  • Hepatitis B Antibodies / immunology*
  • Hepatitis B e Antigens / immunology*
  • Hepatitis B virus / genetics
  • Hepatitis B virus / immunology*
  • Hepatitis B virus / physiology
  • Hepatitis B, Chronic / blood
  • Hepatitis B, Chronic / immunology*
  • Hepatitis B, Chronic / virology
  • Host-Pathogen Interactions / immunology
  • Humans
  • Liver Cirrhosis / blood
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / immunology*
  • Logistic Models
  • Male
  • Prognosis
  • ROC Curve
  • Young Adult

Substances

  • Hepatitis B Antibodies
  • Hepatitis B e Antigens