Serum IgG, definite anti-dsDNA positivity, and advanced HBV-related liver disease: a laboratory-based retrospective...

Immune-serological abnormalities may accompany chronic hepatitis B virus (HBV)-related disease progression, but the relevance of serum immunoglobulin G (IgG) and definite anti-double-stranded DNA (anti-dsDNA) positivity in this setting remains unclear. This study examined their associations with advanced HBV-related liver disease.

This retrospective laboratory-based study included 150 patients with HBV-related liver disease, comprising 50 patients with chronic hepatitis B (CHB), 50 with liver cirrhosis (LC), and 50 with hepatocellular carcinoma (HCC). Advanced HBV-related liver disease was defined as LC or HCC. Multivariable logistic regression was used to evaluate the associations of serum IgG and definite anti-dsDNA positivity with advanced disease after adjustment for age, sex, and antiviral treatment history. Stage-specific analyses, exploratory joint stratification, restricted cubic spline analysis, and sensitivity analyses were also performed.

Serum IgG levels were higher and definite anti-dsDNA positivity was more frequent in patients with advanced HBV-related liver disease than in those with CHB. In the primary multivariable model, serum IgG was associated with advanced disease (OR 1.24 per 1 g/L increase, 95% CI 1.03-1.48, P = 0.021), whereas definite anti-dsDNA positivity showed a positive but statistically borderline association (OR 3.72, 95% CI 0.98-14.20, P = 0.054). Stage-specific analyses suggested that serum IgG was more evident in the CHB-to-LC comparison, whereas definite anti-dsDNA positivity was more evident in the CHB-to-HCC comparison, although estimates involving anti-dsDNA positivity were imprecise. Exploratory joint stratification showed the highest estimated odds of advanced disease among patients with both high serum IgG and definite anti-dsDNA positivity, but subgroup size was small.

Serum IgG showed the most consistent association with advanced HBV-related liver disease in this exploratory laboratory-based cohort. Definite anti-dsDNA positivity showed a weaker, less stable, and stage-dependent signal. These findings suggest that immune-serological markers may provide complementary laboratory information across the HBV-related disease spectrum, but they require validation in larger consecutive cohorts.