The dynamic characteristics and predictive value of hepatitis B core antibody titers in chronic hepatitis B patients treated with interferon

T. Yan, Yuanyuan Li, Yuan Yang, Yingli He, Tianyan Chen, Ying‐ren Zhao, Jinfeng Liu
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Abstract

Objective To observe the dynamic characteristics of hepatitis B core antibody (anti-HBc) titers in chronic hepatitis B (CHB) patients treated with interferon and to explore the predictive value of anti-HBc for response to interferon. Methods The clinical information of the patients diagnosed with CHB in Department of Infectious Diseases, the First Affiliated Hospital of Xi′an Jiaotong University from October 2011 to October 2014 were collected. HBV DNA, liver function and HBV serological markers of CHB patients were tested dynamically during and after interferon treatment. The dynamic characteristics of anti-HBc titers in patients with different virological responses were analyzed. The predictive values of anti-HBc titer for the efficacy of interferon treatment of CHB patients were analyzed by binary logistic regression. Results Of the 42 CHB patients aging(30.8±10.1) years old, 34 patients were hepatitis B e antigen (HBeAg) positive and 8 were negative. All patients completed 48-week interferon treatment and 24-week follow-up after the end of treatment. Among them, 28.6% (12/42), 26.2% (11/42) and 45.2% (19/42) of patients achieved sustained virological response (SVR), virological relapse (VR) and non-response (NR), respectively. Patients with different virological response presented various characteristics of anti-HBc titers. Compared with NR group, the anti-HBc titers at baseline and week 12 were significantly higher in SVR group (at baseline: [4.93 ± 0.30] vs [4.70 ± 0.33] lg IU/mL, t=2.147, P=0.013; at week 12: [4.83 ± 0.23] vs [4.44 ± 0.41] lg IU/mL, t=3.032, P=0.007). The anti-HBc titers in SVR group at week 12 and week 24 were significantly higher than those in VR group (at week 12: [4.83 ± 0.23] vs [4.67 ± 0.51] lg IU/mL, t=2.400, P=0.039; at week 24: [4.73 ± 0.21] vs [4.55 ± 0.50] lg IU/mL, t=2.542, P=0.039). By multivariate logistic regression analysis, the anti-HBc titer at baseline was the independent predictive factor for SVR in CHB patients treated with interferon (OR=6.000, 95%CI: 1.118 - 20.486, P=0.037). The area under receiver operating characteristics curve was 0.753 and the optimal cutoff value of anti-HBc titer for the response to interferons in CHB patients was 5.03 lg IU/mL, with positive predictive value of 64.3% and negative predictive value of 89.3%. Conclusions Dynamic pattern of anti-HBc titers is correlated with different virological responses in CHB patients treated with interferon, and the baseline anti-HBc titer is the independent predictive factor for SVR. Key words: Interferon; Hepatitis B, chronic; Anti-HBc titer
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干扰素治疗慢性乙型肝炎患者乙型肝炎核心抗体滴度的动态特征及预测价值
目的观察干扰素治疗慢性乙型肝炎(CHB)患者乙型肝炎核心抗体(anti-HBc)滴度的动态特征,探讨抗- hbc对干扰素应答的预测价值。方法收集2011年10月至2014年10月西安交通大学第一附属医院感染性疾病科诊断为慢性乙型肝炎患者的临床资料。在干扰素治疗期间和治疗后动态检测CHB患者的HBV DNA、肝功能和HBV血清学标志物。分析不同病毒学反应患者抗hbc滴度的动态特征。采用二元logistic回归分析抗hbc滴度对慢性乙型肝炎患者干扰素治疗效果的预测价值。结果42例CHB患者(30.8±10.1)岁,HBeAg阳性34例,阴性8例。所有患者均完成48周干扰素治疗,治疗结束后随访24周。其中,28.6%(12/42)、26.2%(11/42)和45.2%(19/42)的患者达到持续病毒学应答(SVR)、病毒学复发(VR)和无应答(NR)。不同病毒学反应的患者抗hbc滴度表现出不同的特点。与NR组比较,SVR组基线和第12周抗hbc滴度显著升高(基线时:[4.93±0.30]vs[4.70±0.33]lg IU/mL, t=2.147, P=0.013;第12周:[4.83±0.23]vs[4.44±0.41]lg IU/mL, t=3.032, P=0.007)。SVR组第12、24周抗hbc滴度显著高于VR组(第12周:[4.83±0.23]vs[4.67±0.51]lg IU/mL, t=2.400, P=0.039;第24周:[4.73±0.21]vs[4.55±0.50]lg IU/mL, t=2.542, P=0.039)。多因素logistic回归分析显示,基线抗hbc滴度是干扰素治疗CHB患者SVR的独立预测因素(OR=6.000, 95%CI: 1.118 ~ 20.486, P=0.037)。受试者工作特征曲线下面积为0.753,CHB患者对干扰素反应的抗- hbc滴度最佳临界值为5.03 lg IU/mL,阳性预测值为64.3%,阴性预测值为89.3%。结论干扰素治疗CHB患者抗hbc滴度动态模式与不同病毒学反应相关,基线抗hbc滴度是SVR的独立预测因素。关键词:干扰素;慢性乙型肝炎;Anti-HBc效价
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