Premium
Prognostic value of anti‐HBc quantification in hepatitis B virus related acute‐on‐chronic liver failure
Author(s) -
Li Jing,
Gong Qiming,
Xie Peilin,
Lin Junyu,
Chen Jia,
Wei Dong,
Yu Demin,
Han Yue,
Zhang Xinxin
Publication year - 2021
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.15310
Subject(s) - medicine , hepatitis b virus , nomogram , gastroenterology , receiver operating characteristic , hepatitis b , logistic regression , liver disease , hbsag , immunology , virus
Background and Aim It has been reported that serum quantification of anti‐HBc (qAnti‐HBc) could predict antiviral response in chronic hepatitis B (CHB) patients, while its role in hepatitis B virus‐related acute‐on‐chronic liver failure (HBV‐ACLF) remains unclear. Its implication in HBV‐ACLF was evaluated in this study. Methods Baseline serum qAnti‐HBc levels were retrospectively detected in HBV‐ACLF and CHB patients using recently developed double‐sandwich immunoassay. The association of qAnti‐HBc level with clinical outcomes was evaluated by multiple logistic regression. Nomogram was adopted to formulate an algorithm incorporating qAnti‐HBc for the prediction of survival in HBV‐ACLF. The post‐hospitalization of HBV‐ACLF patients were followed‐up for 1 year. Results Eighty‐eight HBV‐ACLF as training set, 80 HBV‐ACLF as validation set and 216 CHB cases were included. Serum qAnti‐HBc level was significantly higher in HBV‐ACLF (4.95 ± 0.54 log 10 IU/mL) than CHB patients (4.47 ± 0.84 log 10 IU/mL) ( P < 0.01). Among HBV‐ACLF cases, both in training and validation set, patients with poor outcomes had lower qAnti‐HBc level. Area under receiver operating characteristic curve of the novel qAnti‐HBc inclusive model was 0.82, superior to 0.73 from model for end‐stage liver disease scores ( P = 0.018), which was confirmed in validation set. During follow‐up, the qAnti‐HBc level declined at month 3 and month 6, then plateaued at 3.84 log 10 IU/mL. Conclusions Serum qAnti‐HBc level was associated with disease severity and might be served as a novel biomarker in the prediction of HBV‐ACLF clinical outcomes. The underlying immunological mechanism warrants further investigation.