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

// Min-ran Li 1 , Huan-wei Zheng 1 , Jian-hua Lu 1 , Shun-mao Ma 2 , Li-hong Ye 1 , Zhi-quan Liu 1 , Hai-cong Zhang 1 , Yun-yan Liu 1 , Ying Lv 1 , Yan Huang 1 , Er-hei Dai 1 , Dian-xing Sun 3 1 Division of Liver Disease, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, China 2 Department of General Surgery, Huabei Petroleum General Hospital, Renqiu, China 3 Department of Liver Diseases, Bethune International Peace Hospital, Shijiazhuang, China Correspondence to: Er-hei Dai, email: daieh2008@126.com Dian-xing Sun, email: sundianxing@hotmail.com Keywords: diagnostics, quantitative anti-HBc, chronic hepatitis B, liver fibrosis Received: June 20, 2016      Accepted: December 16, 2016      Published: December 28, 2016 ABSTRACT Background: Previous studies have revealed that hepatitis B core antibody (anti-HBc) levels vary throughout the different phases of treatment-naive 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-naive 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-naive 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.