J Viral Hepat. 2018 Dec 21. doi: 10.1111/jvh.13054. [Epub ahead of print]
Serum Hepatitis B core-related antigen is an effective tool to categorize patients with HBeAg-negative Chronic Hepatitis B.
Loggi E1, Vukotic R1, Conti F1, Grandini E1, Gitto S1, Cursaro C1, Galli S2, Furlini G2, Re MC2, Andreone P1.
Author information
1
Dipartimento di Scienze Mediche e Chirurgiche, Centro di Ricerca per lo Studio delle Epatiti, Università degli Studi di Bologna, Bologna, Italy.
2
Dipartimento di Medicina Specialistica, Diagnostica e Sperimentali-UO di Microbiologia, Università degli Studi di Bologna Bologna, Italy.
Abstract
The discrimination between active chronic hepatitis B (CHB) and the clinically quiescent infection (CIB) is not always easy, as a significant portion of patients fall in a "grey" zone. Hepatitis B core-related antigen (HBcrAg) is a now quantifiable serological marker with potential applications in diagnosis and therapy monitoring. The aim of the present study was to evaluate the HBcrAg serum levels in HBeAg negative HBV infection, and its ability in identifying the clinical profile, in comparison with HBsAg serum levels. HBcrAg was retrospectively assessed on serum samples from a population of treatment-naive HBeAg negative patients by ChemiLuminescent Enzyme Immunoassay (CLEIA). HBsAg and HBV-DNA data were collected. Serological data were associated to clinical profile, defined in the subsequent follow-up of at least one year. In the overall population of 160 HBeAg negative patients, HBcrAg results weakly correlated with qHBsAg levels (Spearman r=0.471, p<0.0001) and correlated closely with HBV-DNA (Spearman r=0.746, p<0.0001). HBcrAg levels were significantly higher in 85 CHB patients relative to 75 CIB carriers. A value of 2.5 logU/mL produced the optimal cut-off to identify CIB patients, with diagnostic accuracy comparable to HBsAg levels. In long-term clinical evaluation, a single measurement of HBcrAg at the established cut-off was optimally consistent with clinical outcome. Conversely, the HBsAg cut-off performed well in the true quiescent phase, and less in more difficult to categorize-patients. In conclusion, single-point use of HBcrAg serum levels provides an accurate identification of CIB, and represents a useful tool for patient classification. This article is protected by copyright. All rights reserved.
KEYWORDS:
1
Dipartimento di Scienze Mediche e Chirurgiche，Centro di Ricerca per lo Studio delle Epatiti，UniversitàdegliStudi di Bologna，Bologna，Italy。
2
Dipartimento di Medicina Specialistica，Diagnostica e Sperimentali-UO di Microbiologia，UniversitàdegliStudi di Bologna Bologna，Italy。
抽象
活跃的慢性乙型肝炎（CHB）与临床静息感染（CIB）之间的区别并不总是容易的，因为很大一部分患者属于“灰色”区域。乙型肝炎核心相关抗原（HBcrAg）是一种现已量化的血清学标志物，可用于诊断和治疗监测。本研究的目的是评估HBeAg阴性HBV感染的HBcrAg血清水平，以及与HBsAg血清水平相比较的鉴定临床特征的能力。通过化学发光酶免疫测定法（CLEIA）对来自未治疗的HBeAg阴性患者群体的血清样品进行回顾性评估HBcrAg。收集HBsAg和HBV-DNA数据。血清学数据与临床特征相关，在随后的至少一年的随访中定义。在160名HBeAg阴性患者的总体人群中，HBcrAg结果与qHBsAg水平微弱相关（Spearman r = 0.471，p <0.0001）并且与HBV-DNA密切相关（Spearman r = 0.746，p <0.0001）。相对于75个CIB携带者，85个CHB患者的HBcrAg水平显着升高。 2.5 logU / mL的值产生了识别CIB患者的最佳截止值，诊断准确度与HBsAg水平相当。在长期临床评估中，在确定的临界值下单次测量HBcrAg与临床结果最佳一致。相反，HBsAg截止在真正的静止阶段表现良好，而在更难以分类的患者中表现较差。总之，HBcrAg血清水平的单点使用提供了CIB的准确鉴定，并且代表了用于患者分类的有用工具。本文受版权保护。版权所有。
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