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Published on: December 15, 2023
Quantitative Anti-HBc in Liver Pathological States in Patients with Chronic Hepatitis B Virus Infection
Zhan-Qing Zhang1, Bi-Sheng Shi2, Wei Lu1
1Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center of Fudan University, Shanghai, China.
Insights
Hepatitis B core antigen antibody (anti-HBc) levels increase with liver disease severity in chronic hepatitis B virus (HBV) patients. While useful, anti-HBc is an imperfect marker for monitoring liver pathology progression.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- The role of hepatitis B core antigen antibody (anti-HBc) in liver pathology of chronic hepatitis B virus (HBV) infection requires detailed investigation.
- Understanding anti-HBc dynamics is crucial for managing chronic HBV.
Purpose of the Study:
- To explore evolving patterns of anti-HBc in relation to liver pathological states.
- To assess the validity of anti-HBc as a predictor of liver pathological states in chronic HBV patients.
Main Methods:
- Enrolled 254 HBeAg-positive and 237 HBeAg-negative patients with chronic HBV infection.
- Assessed liver pathology using Scheuer standard criteria.
- Quantified anti-HBc levels via chemiluminescence microparticle immunoassay.
Main Results:
- Anti-HBc showed a significant positive correlation with pathological grades and stages in both HBeAg-positive and HBeAg-negative patients.
- Median anti-HBc levels were significantly lower in HBeAg-positive patients across all pathological grades and stages compared to HBeAg-negative patients.
- Anti-HBc demonstrated moderate accuracy in predicting advanced pathological grades (≥G2, ≥G3) and stages (≥S2, =S4) in both patient groups.
Conclusions:
- Anti-HBc levels gradually increase with hepatic necroinflammation and fibrosis progression in chronic HBV patients.
- The marker shows a differential pattern between HBeAg-positive and HBeAg-negative individuals.
- Anti-HBc is a valuable, though not entirely satisfactory, biomarker for monitoring liver pathological states in chronic HBV.
Background:
Changes of hepatitis B core antigen antibody (anti-HBc) in liver pathological involvement in patients with chronic hepatitis B virus (HBV) infection have not been investigated in detail. This study aimed to explore evolving patterns of anti-HBc following liver pathological states and to investigate validities of anti-HBc for predicting liver pathological states.
Methods:
254 HBeAg-positive and 237 HBeAg-negative patients with chronic HBV infection were enrolled. Liver pathological diagnoses referred to Scheuer standard, and anti-HBc was measured using chemiluminescence microparticle immunoassay.
Results:
Anti-HBc was significantly positively correlated with pathological grades and stages in both HBeAg-positive (r = 0.312, P < 0.0001, and r = 0.268, P < 0.0001) and HBeAg-negative (r = 0.270, P < 0.0001, and r = 0.147, P=0.0237) patients. The medians of anti-HBc in pathological grades of G1, G2, and G3 and stages of S1, S2, S3, and S4 in HBeAg-positive patients were all significantly lower than those in HBeAg-negative patients (all P < 0.005). The areas under receiver-operating characteristic curves (95% confidence interval) of anti-HBc for predicting pathological grades ≥G2 and ≥G3, and stages ≥S2 and =S4 in HBeAg-positive patients were 0.683 (0.622-0.740) and 0.662 (0.601-0.720), and 0.627 (0.564-0.687) and 0.683 (0.622-0.740), respectively, and in HBeAg-negative patients were 0.681 (0.618-0.740) and 0.702 (0.639-0.760), and 0.569 (0.503-0.633) and 0.630 (0.565-0.691), respectively.
Conclusion:
Following hepatic aggravation of necroinflammation and progression of fibrosis, anti-HBc increases gradually in HBeAg-positive patients and continues to increase gradually in HBeAg-negative patients, which is a useful but unsatisfactory marker for monitoring pathological states.
