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Baseline hepatitis B core antibody predicts treatment response in chronic hepatitis B patients receiving long‐term entecavir
Author(s) -
Xu J.H.,
Song L.W.,
Li N.,
Wang S.,
Zeng Z.,
Si C.W.,
Li J.,
Mao Q.,
Zhang D.Z.,
Tang H.,
Sheng J.F.,
Chen X.Y.,
Ning Q.,
Shi G.F.,
Xie Q.,
Yuan Q.,
Yu Y.Y.,
Xia N.S.
Publication year - 2017
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.12626
Subject(s) - entecavir , medicine , seroconversion , hbeag , serology , gastroenterology , hepatitis b , confidence interval , chronic hepatitis , antibody , hepatitis b virus , immunology , hbsag , virus , lamivudine
Summary Studies regarding the clinical significance of quantitative hepatitis B core antibody (anti‐HBc) in patients with chronic hepatitis B receiving first‐line nucleos(t)ide analogues is limited. The aim of this study was to determine the performance of anti‐HBc as a predictor for hepatitis B e antigen (HBeAg) seroconversion in HBeAg‐positive CHB patients treated with entecavir. This was a retrospective cohort study consisting of 139 Chinese patients enrolled in a multicenter clinical trial treated with entecavir or entecavir maleate for up to 240 weeks. Anti‐HBc evaluation was conducted for all the available samples using a newly developed double‐sandwich anti‐HBc immunoassay. At week 240, 35 (25.2%) patients achieved a serological response (HBeAg seroconversion) and these patients at week 240 had significantly higher levels of anti‐HBc ( P <.01). We defined 4.65 log 10 IU·mL −1 , with a maximum sum of sensitivity and specificity, as the optimal cut‐off value of baseline anti‐HBc level to predict seroconversion. Patients with baseline anti‐HBc ≥4.65 log 10 IU·mL −1 had 28.0% (26/93) and 35.5% (33/93) chance of seroconversion at weeks 144 and 240, respectively. The baseline anti‐HBc level was the strongest predictor for seroconversion at week 144 (OR: 5.78, 95% confidence interval [CI]: 2.05‐16.34, P =.001). The baseline anti‐HBc level was a strong predictor for seroconversion at week 240 (OR: 5.36, 95% CI: 2.17‐13.25, P <.001). Hence, baseline anti‐HBc titre is a useful predictor of long‐term entecavir therapy efficacy in HBeAg‐positive CHB patients, which could be used to optimize antiviral therapy.