title: 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.affiliation: From the Center for Liver Diseases and Department of Infectious Diseases (WJ, Y-QF, JL, Y-QD, YW, NH, MY, H-LX, DL, Y-XZ, G-QW), Peking University First Hospital, Beijing; State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics (L-WS, N-SX), National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Xiamen UniversityFujian; and Department of Infectious Diseases (X-FW, D-YL, CX, X-MW, WW, D-XL, M-XZ), Sixth Hospital of ShenyangLiaoning, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Jia
authors.forename: Liu-Wei
authors.initials: LW
authors.lastname: Song
authors.forename: Yu-Qing
authors.initials: YQ
authors.lastname: Fang
authors.forename: Xiao-Feng
authors.initials: XF
authors.lastname: Wu
authors.forename: Dan-Yang
authors.initials: DY
authors.lastname: Liu
authors.forename: Chun
authors.initials: C
authors.lastname: Xu
authors.forename: Xiao-Mei
authors.initials: XM
authors.lastname: Wang
authors.forename: Wen
authors.initials: W
authors.lastname: Wang
authors.forename: Dong-Xia
authors.initials: DX
authors.lastname: Lv
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: Yong-Qiong
authors.initials: YQ
authors.lastname: Deng
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.forename: Na
authors.initials: N
authors.lastname: Huo
authors.forename: Min
authors.initials: M
authors.lastname: Yu
authors.forename: Hong-Li
authors.initials: HL
authors.lastname: Xi
authors.forename: Dan
authors.initials: D
authors.lastname: Liu
authors.forename: Yi-Xing
authors.initials: YX
authors.lastname: Zhou
authors.forename: Gui-Qiang
authors.initials: GQ
authors.lastname: Wang
authors.forename: Ning-Shao
authors.initials: NS
authors.lastname: Xia
authors.forename: Ming-Xiang
authors.initials: MX
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D016022:Case-Control Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006510:Hepatitis B Antibodies / Q000097:blood*; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000276:immunology*; D006801:Humans; D007108:Immune Tolerance; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D000410:Alanine Transaminase