title: Serum hepatitis B core antibody titer use in screening for significant fibrosis in treatment-naïve patients with chronic hepatitis B.
abstract: BACKGROUND
  Previous studies have revealed that hepatitis B core antibody (anti-HBc) levels vary throughout the different phases of treatment-naïve chronic hepatitis B (CHB) patients and can be used as a predictor of treatment response in both interferon-α and nucleoside analogue therapies. However, few data have been published regarding the relationship between quantitative anti-HBc (qAnti-HBc) levels and liver fibrosis in patients with CHB.
  
  
  RESULTS
  A total of 489 HBeAg-positive (HBeAg (+)) and 135 HBeAg-negative (HBeAg (-)) patients were recruited. In both HBeAg (+) and HBeAg (-) groups, the S0-1/S0 subjects had significantly lower qAnti-HBc levels than the S2-4 subjects (p < 0.05). Multiple logistic regression analysis showed that the parameters for predicting significant fibrosis (S ≥ 2) included age, PLT and qAnti-HBc. In HBeAg (+) subjects, the AUROC of qAnti-HBc for predicting significant fibrosis was 0.734 (95% CI 0.689 to 0.778) and the optimal cut-off was 4.58 log10IU/mL, with a sensitivity of 63.08% and a specificity of 74.83%. In HBeAg (-) subjects, the AUROC was 0.707 (95% CI 0.612 to 0.801) and the optimal cut-off value was 4.37 log10IU/mL, with a sensitivity of 75.53% and a specificity of 56.10%.
  
  
  METHODS
  From 2012 to 2015, we conducted a cross-sectional study of treatment-naïve CHB patients. Liver biochemistry, hepatitis B virus (HBV) serological markers, HBV DNA, hepatitis B surface antigen (HBsAg) titers and HBV genotype were determined using commercial assays, and serum qAnti-HBc levels were measured using double-sandwich immunoassay. Liver biopsies and serum samples were obtained on the same day.
  
  
  CONCLUSIONS
  The present study showed an association between high serum qAnti-HBc levels and significant fibrosis (S ≥ 2) in treatment-naïve CHB patients. Furthermore, we described a serum qAnti-HBc cut-off for predicting significant fibrosis in CHB patients infected with HBV genotype B or C.
authors.affiliation: Division of Liver Disease, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, China.
authors.forename: Min-Ran
authors.initials: MR
authors.lastname: Li
authors.affiliation: Division of Liver Disease, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, China.
authors.forename: Huan-Wei
authors.initials: HW
authors.lastname: Zheng
authors.affiliation: Division of Liver Disease, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, China.
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Lu
authors.affiliation: Department of General Surgery, Huabei Petroleum General Hospital, Renqiu, China.
authors.forename: Shun-Mao
authors.initials: SM
authors.lastname: Ma
authors.affiliation: Division of Liver Disease, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, China.
authors.forename: Li-Hong
authors.initials: LH
authors.lastname: Ye
authors.affiliation: Division of Liver Disease, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, China.
authors.forename: Zhi-Quan
authors.initials: ZQ
authors.lastname: Liu
authors.affiliation: Division of Liver Disease, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, China.
authors.forename: Hai-Cong
authors.initials: HC
authors.lastname: Zhang
authors.affiliation: Division of Liver Disease, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, China.
authors.forename: Yun-Yan
authors.initials: YY
authors.lastname: Liu
authors.affiliation: Division of Liver Disease, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Lv
authors.affiliation: Division of Liver Disease, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Division of Liver Disease, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, China.
authors.forename: Er-Hei
authors.initials: EH
authors.lastname: Dai
authors.affiliation: Department of Liver Diseases, Bethune International Peace Hospital, Shijiazhuang, China.
authors.forename: Dian-Xing
authors.initials: DX
authors.lastname: Sun
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005838:Genotype; D006510:Hepatitis B Antibodies / Q000097:blood / Q000276:immunology*; D006513:Hepatitis B e Antigens / Q000276:immunology*; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology* / Q000502:physiology; D019694:Hepatitis B, Chronic / Q000097:blood / Q000276:immunology* / Q000821:virology; D054884:Host-Pathogen Interactions / Q000276:immunology; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D016015:Logistic Models; D008297:Male; D011379:Prognosis; D012372:ROC Curve; D055815:Young Adult
chemical_list: D006510:Hepatitis B Antibodies; D006513:Hepatitis B e Antigens
keywords: chronic hepatitis B; diagnostics; liver fibrosis; quantitative anti-HBc