Dose-response relationship between qAnti-HBc and liver inflammation in chronic hepatitis B with normal or mildly elevated ALT based on liver biopsy
Chi Zhang 1 , Yiqi Liu 1 , Jiawen Li 1 , Hui Liu 2 , Chen Shao 2 , Dan Liu 1 , Min Yu 1 , Hongli Xi 1 , Hong Zhao 1 3 , Guiqiang Wang 1 3
Affiliations
Affiliations
1
Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, Beijing, 100034, China.
2
Department of Pathology, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.
3
Department of Infectious Diseases, Peking University International Hospital, Beijing, 102206, China.
PMID: 35419853 DOI: 10.1002/jmv.27779
Abstract
Background: The proportion of chronic hepatitis B(CHB) patients with normal or mildly elevated ALT(NMALT) levels who have moderate to severe inflammation was not rare. However, we lacked appropriate biomarkers to evaluate liver inflammation in these populations. We aimed to explore the relationship between quantitative hepatitis B core antibody(qAnti-HBc) and hepatic histological inflammation.
Method: This multi-center cohort study enrolled participants from 34 Chinese hospital including 1376 treatment-naive CHB patients with liver biopsy(934 with NMALT entered treatment-naive cohort; 423 with secondary liver biopsy entered treatment cohort). Using unadjusted and multivariate-adjusted generalized linear models, generalized additive models with smooth curve fitting, we evaluated the associations between qAnti-HBc and liver inflammation in these patients.
Results: In the treatment-naive patients, qAnti-HBc was positively associated with liver inflammation(histology activity index[HAI] evaluated by Ishak scoring system)(fully-adjusted model: β=0.48, 95%CI[0.30-0.66], P<0.001). For per-SD increase in qAnti-HBc, the risk of moderate to severe inflammation(HAI≥5) increased by 56%(OR=1.56, 95%CI[1.28-1.91], P<0.001). The curve fitting indicated a significant "threshold effect" (inflection point was 4.5 log10 IU/mL, P<0.001). Subgroup analyses and interactions were not significant(all P>0.05). In the treatment patients, there was no significant correlation between qAnti-HBc and liver inflammation, whether based on unadjusted, minimally-adjusted, or fully-adjusted models(all P>0.100). Paired analyses showed a significant correlation between decreasing in qAnti-HBc and alleviation of liver inflammation.
Conclusions: qAnti-HBc was positively correlated with liver inflammation in treatment-naive CHB patients with NMALT. The cutoff value of qAnti-HBc for the diagnosis of moderate to severe inflammation was 4.5 log10 IU/mL. Decreasing in qAnti-HBc was positively correlated with liver inflammation relieving. This article is protected by copyright. All rights reserved.
Keywords: chronic hepatitis B; liver biopsy; liver inflammation; normal or mildly elevated ALT; quantitative hepatitis B core antibody.
This article is protected by copyright. All rights reserved.