Antibody to hepatitis B core antigen levels in the natural history of chronic hepatitis B: a prospective observational study.

Abstract

Previous studies have revealed antibody to hepatitis B core antigen (anti-HBc) levels as a predictor of treatment response in hepatitis B early antigen (HBeAg)-positive chronic hepatitis B (CHB) patients in both interferon and nucleos(t)ide analog therapy cohorts. However, there is no information about anti-HBc levels in the natural history of CHB. This study aimed to define anti-HBc levels of different phases in the natural history of CHB. Two hundred eleven treatment-naive CHB patients were included in the study. They were classified into 4 phases: immune tolerance (IT) phase (n = 39), immune clearance (IC) phase (n = 48), low or no-replicative (LR) phase (n = 55), and HBeAg-negative hepatitis (ENH, n = 69). Fifty patients who were HBsAg negative and anti-HBc positive were also recruited as past HBV infection (PBI) control group. Anti-HBc levels were measured by a newly developed double-sandwich immunoassay. Correlation of anti-HBc levels with alanine aminotransferase (ALT) and other HBV-related markers within each phase was performed. Serum anti-HBc levels were statistically significant between patients in different phases of CHB (P < 0.001). The median anti-HBc levels were: IT (3.17 log 10 IU/mL), IC (4.39 log 10 IU/mL), LR (3.29 log 10 IU/mL), ENH (4.12 log 10 IU/mL), and PBI (0.61 log 10 IU/mL). There existed a strong correlation in IC (r = 0.489, P < 0.001), a poor correlation in ENH (r = 0.275, P = 0.042), and no correlation in patients with ALT reached 5 times upper limit of normal (r = 0.120, P = 0.616). Anti-HBc levels show significant differences during the natural course of CHB. These results may provide some potentially useful insights into hepatitis B pathogenesis and immune activation against hepatitis B virus.

• Authors: Wei Jia, Liu-Wei Song, Yu-Qing Fang, Xiao-Feng Wu, Dan-Yang Liu, Chun Xu, Xiao-Mei Wang, Wen Wang, Dong-Xia Lv, Jun Li, Yong-Qiong Deng, Yan Wang, Na Huo, Min Yu, Hong-Li Xi, Dan Liu, Yi-Xing Zhou, Gui-Qiang Wang, Ning-Shao Xia, Ming-Xiang Zhang
• Journal: Medicine (Medicine (Baltimore)) Vol. 93 Issue 29 Pg. e322 (Dec 2014) ISSN: 1536-5964 [Electronic] United States
• PMID: 25546679 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)

Chemical References

• DNA, Viral
• Hepatitis B Antibodies
• Hepatitis B Core Antigens
• Alanine Transaminase

Topics

• Adolescent
• Adult
• Aged
• Alanine Transaminase (blood)
• Case-Control Studies
• DNA, Viral (analysis)
• Female
• Hepatitis B Antibodies (blood)
• Hepatitis B Core Antigens (immunology)
• Hepatitis B virus (genetics, immunology)
• Hepatitis B, Chronic (immunology)
• Humans
• Immune Tolerance
• Male
• Middle Aged
• Prospective Studies
• Young Adult