Correlations between serum hepatitis B surface antigen and hepatitis B core antibody titers and liver fibrosis in treatment-naïve CHB patients

• Published in: Journal of the Chinese Medical Association Vol. 81; no. 12; pp. 1052 - 1059
• Main Authors: Li, Min-Ran, Zheng, Huan-Wei, Ma, Shun-Mao, Liu, Yun-Yan, Qie, Lan-Xia, Li, Jun-Qing, Wang, De-Hua, Sun, Xing-Li, Ren, Gui-Fang, Zheng, Yan-Hua, Wang, Yu-Ling, Dai, Er-Hei
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Taiwan LLC 01.12.2018
• Subjects: Adult; Chronic hepatitis B; Cross-Sectional Studies; Female; Hepatitis B Antibodies - blood; Hepatitis B Core Antigens - immunology; Hepatitis B surface antigen; Hepatitis B Surface Antigens - blood; Hepatitis B virus - classification; Hepatitis B virus - genetics; Hepatitis B, Chronic - complications; Humans; Liver - pathology; Liver Cirrhosis - etiology; Liver Cirrhosis - microbiology; Liver Cirrhosis - pathology; Liver fibrosis; Logistic Models; Male; Middle Aged; Quantitative anti-HBc; Hepatitis B surface antigen; Liver fibrosis; Chronic hepatitis B; Quantitative anti-HBc
• ISSN: 1726-4901; 1728-7731; 1728-7731
• DOI: 10.1016/j.jcma.2018.05.007

Previous studies have revealed that quantitative hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (qAnti-HBc) levels can be used as predictors of treatment response in both interferon-α and nucleoside analogue therapies. Few data have been published regarding the relationship between quantitative HBsAg or Anti-HBc levels and liver fibrosis stages in patients with chronic hepatitis B (CHB). We conducted a cross-sectional study of treatment-naïve CHB patients. A total of 624 CHB patients were recruited. We assessed the serum HBsAg and qAnti-HBc levels, HBV DNA levels, HBV genotypes, BCP/PC mutations, histological fibrosis staging by Scheuer classification. In HBeAg (+) patients, the S0-1 subjects had significantly higher serum HBsAg and lower qAnti-HBc levels than the S2-4 subjects (both p < 0.001). A moderate inverse correlation was present between serum HBsAg levels and fibrosis scores (r = −0.381, p < 0.001), and a moderate positive correlation was found between qAnti-HBc levels and fibrosis scores (r = 0.408, p < 0.001). In the HBeAg (−) patients, the S0-1 subjects also had significantly lower qAnti-HBc levels than the S2-4 subjects (p < 0.001); however, no significant difference in the HBsAg levels was observed between the S0-1 and S2-4 subjects (p > 0.05). Serum qAnti-HBc levels showed a moderate positive correlation with fibrosis scores (r = 0.383, p < 0.001), while serum HBsAg levels exhibited a low inverse correlation with fibrosis scores (r = −0.171, p < 0.001). Multiple logistic regression analysis showed that the parameters for predicting significant fibrosis (S ≥ 2) included age, PLT, qAnti-HBc levels, HBV genotype and BCP/PC mutations in HBeAg (+) group, and age, PLT, qAnti-HBc levels in HBeAg (−) group (all p < 0.05). The AUC of qAnti-HBc levels associated with the diagnosis of significant fibrosis abnormalities in HBeAg (+) and HBeAg (−) patients were 0.734 (95%CI 0.689 to 0.778) and 0.707 (95%CI 0.612 to 0.801), respectively. Our study found an association between high serum qAnti-HBc levels and significant fibrosis in both HBeAg (+) and HBeAg (−) treatment-naïve CHB patients. However, low serum HBsAg levels were correlated with moderate to severe fibrosis in HBeAg (+) subjects only.