title: Baseline hepatitis B core antibody predicts treatment response in chronic hepatitis B patients receiving long-term entecavir.
abstract: Studies regarding the clinical significance of quantitative hepatitis B core antibody (anti-HBc) in patients with chronic hepatitis B receiving first-line nucleos(t)ide analogues 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 entecavir. This was a retrospective cohort study consisting of 139 Chinese patients enrolled in a multicenter clinical trial treated with entecavir or entecavir maleate for up to 240 weeks. Anti-HBc evaluation was conducted for all the available samples using a newly developed double-sandwich anti-HBc immunoassay. At week 240, 35 (25.2%) patients achieved a serological response (HBeAg seroconversion) and these patients at week 240 had significantly higher levels of anti-HBc (P<.01). We defined 4.65 log10IU·mL-1, with a maximum sum of sensitivity and specificity, as the optimal cut-off value of baseline anti-HBc level to predict seroconversion. Patients with baseline anti-HBc ≥4.65 log10IU·mL-1had 28.0% (26/93) and 35.5% (33/93) chance of seroconversion at weeks 144 and 240, respectively. The baseline anti-HBc level was the strongest predictor for seroconversion at week 144 (OR: 5.78, 95% confidence interval [CI]: 2.05-16.34, P=.001). The baseline anti-HBc level was a strong predictor for seroconversion at week 240 (OR: 5.36, 95% CI: 2.17-13.25, P<.001). Hence, baseline anti-HBc titre is a useful predictor of long-term entecavir therapy efficacy in HBeAg-positive CHB patients, which could be used to optimize antiviral therapy.
authors.affiliation: Department of Infectious Diseases, Center for Liver Diseases, Peking University First Hospital, Beijing, China.
authors.forename: J-H
authors.initials: JH
authors.lastname: Xu
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.|Xiamen Innovax Biotech Co., Ltd., Xiamen, China.
authors.forename: L-W
authors.initials: LW
authors.lastname: Song
authors.affiliation: Department of Infectious Diseases, Center for Liver Diseases, Peking University First Hospital, Beijing, China.
authors.forename: N
authors.initials: N
authors.lastname: Li
authors.affiliation: Department of Infectious Diseases, Center for Liver Diseases, Peking University First Hospital, Beijing, China.
authors.forename: S
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Infectious Diseases, Center for Liver Diseases, Peking University First Hospital, Beijing, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Zeng
authors.affiliation: Department of Infectious Diseases, Center for Liver Diseases, Peking University First Hospital, Beijing, China.
authors.forename: C-W
authors.initials: CW
authors.lastname: Si
authors.affiliation: Department of Infectious Diseases, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
authors.forename: J
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Infectious Diseases, Southwest China Hospital, Chongqing, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Mao
authors.affiliation: Institute for Viral Hepatitis, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: D-Z
authors.initials: DZ
authors.lastname: Zhang
authors.affiliation: Department of Infectious Diseases, West China Hospital, Chengdu, China.
authors.forename: H
authors.initials: H
authors.lastname: Tang
authors.affiliation: State Key Laboratory for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: J-F
authors.initials: JF
authors.lastname: Sheng
authors.affiliation: Department of International Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, China.
authors.forename: X-Y
authors.initials: XY
authors.lastname: Chen
authors.affiliation: Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Ning
authors.affiliation: Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: G-F
authors.initials: GF
authors.lastname: Shi
authors.affiliation: Department of Infectious Diseases, Ruijin Hospital, Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Xie
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: Q
authors.initials: Q
authors.lastname: Yuan
authors.affiliation: Department of Infectious Diseases, Center for Liver Diseases, Peking University First Hospital, Beijing, China.
authors.forename: Y-Y
authors.initials: YY
authors.lastname: Yu
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: N-S
authors.initials: NS
authors.lastname: Xia
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D002681:China; D005260:Female; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006510:Hepatitis B Antibodies / Q000097:blood*; D006513:Hepatitis B e Antigens / Q000097:blood*; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D006510:Hepatitis B Antibodies; D006513:Hepatitis B e Antigens; C413685:entecavir; D006147:Guanine
keywords: entecavir; hepatitis; hepatitis B core antibody; treatment outcome