Abstract
The level of CHB virus (HBV) core antibody (HBcAb) is different in four stages of chronic HBV infection and may be used for differential diagnosis of the natural history of chronic HBV infection. To address this question, we examined multiple blood biomarkers and assessed the efficacy to diagnose different stages of chronic HBV infection. The quantitative detection of HBcAb, hepatitis B surface antigen (HBsAg), HBV DNA, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and platelet count (PLT) were determined in the serum of 73 cases of low-replicative phase (LR), 46 cases of immune-tolerant phase (IT), 44 cases of immune clearance phase (IC), and 57 cases of HBeAg-negative hepatitis (ENH). Differentiating performance of these serum protein levels was analyzed by receiver operating characteristic (ROC) curve analysis. Our results showed that the levels of HBcAb, ALT, and AST levels were significantly higher in IC and ENH than those in LR and IT (both P ≤ 0.001). The levels of HBV DNA and HBsAg were higher in IC and IT than those in LR and ENH (both P ≤ 0.001). Logistic regression models showed that HBcAb, HBsAg, HBV DNA, ALT, and AST were the independent variables, respectively, and when combined, they provided high diagnostic accuracy for the staging of CHB. To sum up, HBcAb quantification is a new index, which can reflect whether the liver is in the immune activation state of HBV infection, and is related to the inflammatory state of the host liver. The combined detection of HBcAb quantification and other indicators has showed promising efficiency for staging of IC and ENH and can assist the diagnosis and treatment of CHB.
Highlights
According to the report of World Health Organization (WHO), about 2 billion people in the world have been infected with hepatitis B virus (HBV), among which 350 million people are chronic hepatitis B (CHB) patients. e chronic HBV infection has been a worldwide disease [1]
In patients with chronic HBV infection, the quantitative detection of Hepatitis B core antibody (HBcAb) is related to the inflammatory state of the host liver, which can be diagnosed alone or in combination with other relevant indicators to assist the diagnosis and treatment of chronic HBV. is work benefits the clinical management of CHB from a unique perspective of the quantitative detection of HBcAb
Kruskal–Wallis H-test mean rank multiple comparisons showed that the level of hepatitis B surface antigen (HBsAg) was the lowest in the immune control period, and HBcAb, ALT, and AST levels were significantly higher in the immune clearance and reactivation phases than in the immune control and immune tolerance phases; HBV DNA levels were not statistically different between the immune clearance and immune tolerance phases (P > 0.05), and the levels in both the immune clearance and immune tolerance periods were significantly higher than those in the immune control and reactivation periods (P ≤ 0.001)
Summary
According to the report of World Health Organization (WHO), about 2 billion people in the world have been infected with hepatitis B virus (HBV), among which 350 million people are chronic hepatitis B (CHB) patients. e chronic HBV infection has been a worldwide disease [1]. The quantitative detection of HBcAb is reflecting the natural course of chronic HBV, assisting in the diagnosis of occult HBV infection, predicting and evaluating the antiviral response of HBV and optimizing the diagnosis and treatment of HIV patients by detecting HBcAb during HIV (human immunodeficiency virus)/ HBV mixed infection [7], which plays a certain role in guiding the clinical management of CHB, such as the ability to indirectly reflect anti-HBV immune response and the degree of inflammation in liver tissue [7,8,9]. In patients with chronic HBV infection, the quantitative detection of HBcAb is related to the inflammatory state of the host liver, which can be diagnosed alone or in combination with other relevant indicators to assist the diagnosis and treatment of chronic HBV. In patients with chronic HBV infection, the quantitative detection of HBcAb is related to the inflammatory state of the host liver, which can be diagnosed alone or in combination with other relevant indicators to assist the diagnosis and treatment of chronic HBV. is work benefits the clinical management of CHB from a unique perspective of the quantitative detection of HBcAb
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