Research Papers:

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

Min-ran Li, Huan-wei Zheng, Jian-hua Lu, Shun-mao Ma, Li-hong Ye, Zhi-quan Liu, Hai-cong Zhang, Yun-yan Liu, Ying Lv, Yan Huang, Er-hei Dai and Dian-xing Sun _

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Oncotarget. 2017; 8:11063-11070. https://doi.org/10.18632/oncotarget.14323

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Min-ran Li1, Huan-wei Zheng1, Jian-hua Lu1, Shun-mao Ma2, Li-hong Ye1, Zhi-quan Liu1, Hai-cong Zhang1, Yun-yan Liu1, Ying Lv1, Yan Huang1, Er-hei Dai1, Dian-xing Sun3

1Division of Liver Disease, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, China

2Department of General Surgery, Huabei Petroleum General Hospital, Renqiu, China

3Department of Liver Diseases, Bethune International Peace Hospital, Shijiazhuang, China

Correspondence to:

Er-hei Dai, email: [email protected]

Dian-xing Sun, email: [email protected]

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

Received: June 20, 2016     Accepted: December 16, 2016     Published: December 28, 2016


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.

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