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Serum hepatitis B core-related antigen level stratifies risk of disease progression in chronic hepatitis B patients

Tai-Chung Tseng1,2,3, Chun-Jen Liu1,2,4, Wan-Ting Yang2

  • 1Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

Alimentary Pharmacology & Therapeutics
|January 19, 2021
PubMed

Insights

High hepatitis B core-related antigen (HBcrAg) levels in patients with chronic hepatitis B virus (HBV) infection predict increased cirrhosis risk. A low HBcrAg level (<10 KU/mL) identifies a low-risk group for disease progression in those with intermediate viral load.

Area of Science:

  • Hepatology
  • Virology
  • Biomarker Discovery

Background:

  • Chronic hepatitis B virus (HBV) infection poses a significant risk for liver disease development.
  • Serum hepatitis B core-related antigen (HBcrAg) serves as a novel biomarker reflecting intrahepatic HBV replication.
  • Understanding predictors of liver disease progression is crucial for patient management.

Purpose of the Study:

  • To investigate the association between elevated HBcrAg levels and the risk of cirrhosis development.
  • To specifically assess this risk in patients with intermediate viral load (HBV DNA 2000-19,999 IU/mL).
  • To determine if HBcrAg can stratify risk in this moderate-risk patient group.

Main Methods:

  • A cohort of 1673 treatment-naïve, non-cirrhotic patients with HBeAg-negative status and normal ALT levels were analyzed.
  • Baseline HBcrAg levels were measured and correlated with long-term outcomes, including cirrhosis development.
  • Risk stratification was performed using an HBcrAg cutoff of 10 KU/mL, particularly in patients with intermediate viral load.

Main Results:

  • Over a mean follow-up of 15.9 years, 104 patients developed cirrhosis.
  • Higher baseline HBcrAg levels correlated with increased incidence of cirrhosis, its complications, and liver-related mortality.
  • In the intermediate viral load subgroup (n=445), HBcrAg <10 KU/mL was associated with a significantly lower risk of cirrhosis (HR 3.22).

Conclusions:

  • Elevated HBcrAg levels are a significant predictor of cirrhosis risk in HBeAg-negative patients with normal ALT.
  • The HBcrAg level of <10 KU/mL effectively identifies a low-risk group for disease progression among patients with intermediate HBV viral load.
  • HBcrAg serves as a valuable tool for risk stratification in chronic HBV management.
Abstract

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