title: Baseline quantitative hepatitis B core antibody titre alone strongly predicts HBeAg seroconversion across chronic hepatitis B patients treated with peginterferon or nucleos(t)ide analogues.
abstract: OBJECTIVE
  The investigation regarding the clinical significance of quantitative hepatitis B core antibody (anti-HBc) during chronic hepatitis B (CHB) treatment is limited. The aim of this study was to determine the performance of anti-HBc as a predictor for hepatitis B e antigen (HBeAg) seroconversion in HBeAg-positive CHB patients treated with peginterferon (Peg-IFN) or nucleos(t)ide analogues (NUCs), respectively.
  
  
  METHODS
  This was a retrospective cohort study consisting of 231 and 560 patients enrolled in two phase IV, multicentre, randomised, controlled trials treated with Peg-IFN or NUC-based therapy for up to 2 years, respectively. Quantitative anti-HBc evaluation was conducted for all the available samples in the two trials by using a newly developed double-sandwich anti-HBc immunoassay.
  
  
  RESULTS
  At the end of trials, 99 (42.9%) and 137 (24.5%) patients achieved HBeAg seroconversion in the Peg-IFN and NUC cohorts, respectively. We defined 4.4 log10 IU/mL, with a maximum sum of sensitivity and specificity, as the optimal cut-off value of baseline anti-HBc level to predict HBeAg seroconversion for both Peg-IFN and NUC. Patients with baseline anti-HBc ≥4.4 log10 IU/mL and baseline HBV DNA <9 log10 copies/mL had 65.8% (50/76) and 37.1% (52/140) rates of HBeAg seroconversion in the Peg-IFN and NUC cohorts, respectively. In pooled analysis, other than treatment strategy, the baseline anti-HBc level was the best independent predictor for HBeAg seroconversion (OR 2.178; 95% CI 1.577 to 3.009; p<0.001).
  
  
  CONCLUSIONS
  Baseline anti-HBc titre is a useful predictor of Peg-IFN and NUC therapy efficacy in HBeAg-positive CHB patients, which could be used for optimising the antiviral therapy of CHB.
authors.affiliation: State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Fan
authors.affiliation: State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Sun
authors.affiliation: State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, Xiamen, China.
authors.forename: Quan
authors.initials: Q
authors.lastname: Yuan
authors.affiliation: Department of Infectious Diseases, Ruijin Hospital, Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Xie
authors.affiliation: Department of Infectious Diseases, Tangdu Hospital, Xi'an, China.
authors.forename: Xuefan
authors.initials: X
authors.lastname: Bai
authors.affiliation: Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Ning
authors.affiliation: Beijing Ditan Hospital, Capital Medical University, Beijing, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Cheng
authors.affiliation: Department of Infectious Diseases, First Hospital of Peking University, Beijing, China.
authors.forename: Yanyan
authors.initials: Y
authors.lastname: Yu
authors.affiliation: Department of Hepatology, First Hospital, Jilin University, Changchun, China.
authors.forename: Junqi
authors.initials: J
authors.lastname: Niu
authors.affiliation: Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Guangfeng
authors.initials: G
authors.lastname: Shi
authors.affiliation: Hepatology Unit, Peking University People's Hospital, Beijing, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Infectious Diseases, Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Deming
authors.initials: D
authors.lastname: Tan
authors.affiliation: Department of Infectious Diseases, Changhai Hospital, Shanghai, China.
authors.forename: Mobin
authors.initials: M
authors.lastname: Wan
authors.affiliation: Ji'nan Infectious Diseases Hospital, Ji'nan, China.
authors.forename: Shijun
authors.initials: S
authors.lastname: Chen
authors.affiliation: 8th People's Hospital, Guangzhou, China.
authors.forename: Min
authors.initials: M
authors.lastname: Xu
authors.affiliation: Beijing Youan Hospital, Capital Medical University, Beijing, China.
authors.forename: Xinyue
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Infectious Diseases, West China Hospital, Chengdu, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Tang
authors.affiliation: Department of Infectious Diseases, Zhejiang University 1st Affiliated Hospital, Hangzhou, China.
authors.forename: Jifang
authors.initials: J
authors.lastname: Sheng
authors.affiliation: Department of Microbiology, Health science Center, Peking University, Beijing, China.
authors.forename: Fengmin
authors.initials: F
authors.lastname: Lu
authors.affiliation: Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors.forename: Jidong
authors.initials: J
authors.lastname: Jia
authors.affiliation: Department of Microbiology, Health science Center, Peking University, Beijing, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhuang
authors.affiliation: State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, Xiamen, China.
authors.forename: Ningshao
authors.initials: N
authors.lastname: Xia
authors.affiliation: State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangzhou, China Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China.
authors.forename: Jinlin
authors.initials: J
authors.lastname: Hou
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006510:Hepatitis B Antibodies / Q000032:analysis*; D006513:Hepatitis B e Antigens / Q000276:immunology*; D019694:Hepatitis B, Chronic / Q000276:immunology* / Q000628:therapy; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D009705:Nucleosides / Q000627:therapeutic use*; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D000069078:Seroconversion
chemical_list: D006510:Hepatitis B Antibodies; D006513:Hepatitis B e Antigens; D016898:Interferon-alpha; D009705:Nucleosides; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C100416:peginterferon alfa-2a
keywords: CORE ANTIBODY; HEPATITIS B