Quantitative hepatitis B core antibody levels in the natural history of hepatitis B virus infection

Abstract

We previously demonstrated that pretreatment quantitative anti-hepatitis B core protein (qAnti-HBc) levels can predict the treatment response for both interferon and nucleoside analogue therapy, but the characteristics of qAnti-HBc during chronic hepatitis B virus (HBV) infection remain poorly understood. To understand this issue, the qAnti-HBc levels were evaluated in individuals with past HBV infection, occult HBV infection and chronic HBV infection in the immune tolerance phase, immune clearance phase, low-replicative phase and hepatitis B e antigen (HBeAg)-negative hepatitis phase. Individuals with hepatitis B surface antigen (n = 598, 3.74 ± 0.90 log10 IU/mL) had significantly higher (p < 0.001, approximately 1000-fold) serum qAnti-HBc levels than those who had occult HBV, and serum qAnti-HBc levels were significantly higher in the occult HBV group than in the past HBV infection group (p < 0.001). qAnti-HBc levels were positively correlated with alanine aminotransferase levels (R = 0.663, p < 0.001), and subjects with an abnormal alanine aminotransferase level had a higher qAnti-HBc level (p < 0.001). Serum qAnti-HBc level varied in different phases of HBV infection, as determined by host immune status. Serum qAnti-HBc level is strongly associated with hepatitis activity in subjects with chronic HBV infection.

Total hepatitis B core antigen antibody, a quantitative non-invasive marker of hepatitis B virus induced liver disease

“…Our validation study confirms in well characterized HBsAg-carriers infected with genotype-D-HBV the results obtained in Asian patients infected with genotype B and C [21]; the highest levels of total-anti-HBc were detected in CHB, both HBeAg-positive and HBeAg-negative and the lowest levels in inactive-carriers (Fig 1). Very low levels of the antibody were reported in the non-inflammatory, HBeAg-positive immune-tolerant-phase in genotype-B and-C infections [21][22][23]. Consistently in our HBeAg-positive-carriers total-antiHBc levels comparable to those of inactive-carriers were found only in an immune-tolerant carrier, whereas the remaining CHB-patients showed high antibody levels.…”

“…However, in HBeAgnegative CHB patients undergoing antiviral treatment HBsAg kinetics vary according to HBV genotype and genotype-specific monitoring timeframes and end-of-treatment thresholds have yet to be standardized for a proper response-guided treatment 19]. Recently a new assay based on double antigen sandwich method that detects total (IgG and IgM) anti-HBc was developed and proposed to monitor patients, chronically infected with genotype B and C HBV undergoing antiviral therapy [21][22][23][24]. We tested this assay in a validation study on a panel of sera from well characterized genotype D, HBsAg carriers.…”

Role of serum hepatitis B virus marker quantitation to differentiate natural history phases of HBV infection

“…No cutoff value can confidently predict the disease activity due to significant overlap of HBsAg levels among patients with active and inactive diseases [14]. Furthermore, there is little information about hepatitis B core antibody (HBcAb) levels in the natural history of CHB [15,16]. And no data are available on hepatitis B e antigen (HBeAg) for differentiation of the natural phases of HBV infection.…”

Diagnostic Value of the Quantitative Titer of High-Sensitivity C-Reactive Protein in the Detection of Clinical Stages of Chronic Hepatitis B Infection

“…The sensitivity limit was 0.25 mg/L and the upper limit was set at 18 mg/L. The patients were categorized into four groups, based on the clinical phase of HBV infection (i.e., immunetolerant, immune-clearance, HBeAg-negative, and lowreplicative phases), according to the criteria presented in Table 1 (16,17). The classification of these patients was in accordance with the European association for the study of the liver (EASL) criteria presented in 2012 (18).…”