Quantitative HBcrAg and HBcAb versus HBsAg and HBV DNA in predicting liver fibrosis levels of chronic hepatitis B patients.

Abstract

OBJECTIVE:

To evaluate the performance of the quantitative markers of hepatitis B core-related antigen (HBcrAg) and anti-hepatitis B core antigen antibodies HbcAb versus hepatitis B surface antigen (HBsAg) and hepatitis B virus DNA (HBV DNA) in predicting liver fibrosis levels in chronic hepatitis B patients.

METHODS:

Two hundred and fifty hepatitis B e antigen (HBeAg)-positive and 245 HBeAg-negative patients were enrolled. With reference to the Scheuer standard, stage 2 or higher and stage 4 liver disease were defined as significant fibrosis and cirrhosis, respectively. A receiver operating characteristic (ROC) curve was used to evaluate the performance of the HBV markers investigated.

RESULTS:

The areas under the ROC curves (AUCs) of HBcrAg in predicting significant fibrosis and cirrhosis in HBeAg-positive patients (0.577 and 0.700) were both close to those of HBsAg (0.617 and 0.762) (both P> 0.05). In HBeAg-negative patients (0.797 and 0.837), they were both significantly greater than those of HBV DNA (0.723 and 0.738) (P=0.0090 and P=0.0079). The AUCs of HBcAb in predicting significant fibrosis and cirrhosis in HBeAg-positive patients (0.640 and 0.665) were both close to those of HBsAg. In HBeAg-negative patients (0.570 and 0.621), they were both significantly less than those of HBcrAg (P <0.0001 and P=0.0001). Specificity in predicting significant fibrosis and sensitivity in predicting cirrhosis in HBeAg-positive patients, using a single cut-off of HBsAg ≤5,000 IU/ml, were 76.5% and 72.7%, respectively. In HBeAg-negative patients, using a single cut-off of HBcrAg>80kU/ml, they were 85.9% and 81.3%, respectively.

CONCLUSIONS:

HBsAg has good performance in predicting liver fibrosis levels in HBeAg-positive and HBeAg-negative patients, and HBcrAg has very good performance in predicting liver fibrosis levels in HBeAg-negative patients.

• Authors: Zhan-Qing Zhang, Bi-Sheng Shi, Wei Lu, Dan-Ping Liu, Dan Huang, Yan-Ling Feng
• Journal: Gastroenterologia y hepatologia (Gastroenterol Hepatol) Vol. 43 Issue 9 Pg. 526-536 (Nov 2020) ISSN: 0210-5705 [Print] Spain
• PMID: 32921478 (Publication Type: Comparative Study, Journal Article, Review)
• Copyright: Copyright © 2020. Publicado por Elsevier España, S.L.U.

Chemical References

• Biomarkers
• DNA, Viral
• Hepatitis B Antibodies
• Hepatitis B Core Antigens
• Hepatitis B Surface Antigens

Topics

• Biomarkers (blood)
• DNA, Viral (blood)
• Hepatitis B Antibodies (blood)
• Hepatitis B Core Antigens (blood)
• Hepatitis B Surface Antigens (blood)
• Hepatitis B virus (genetics)
• Hepatitis B, Chronic (blood, complications)
• Humans
• Liver Cirrhosis (blood, etiology)
• Predictive Value of Tests