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Serum hepatitis B core‐related antigen is an effective tool to categorize patients with HB eAg‐negative chronic hepatitis B
Author(s) -
Loggi Elisabetta,
Vukotic Ranka,
Conti Fabio,
Grandini Elena,
Gitto Stefano,
Cursaro Carmela,
Galli Silvia,
Furlini Giuliano,
Re Maria Carla,
Andreone Pietro
Publication year - 2019
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.13054
Subject(s) - medicine , serology , hbsag , gastroenterology , population , chronic hepatitis , antigen , immunology , hepatitis b , immunoassay , seroconversion , hepatitis b virus , antibody , virus , environmental health
Summary The discrimination between active chronic hepatitis B ( CHB ) and the clinically quiescent infection ( CIB ) is not always easy, as a significant portion of patients falls in a “grey” zone. Hepatitis B core‐related antigen ( HB crAg) is a now quantifiable serological marker with potential applications in diagnosis and therapy monitoring. The aim of the present study was to evaluate the HB crAg serum levels in HB eAg‐negative HBV infection, and its ability in identifying the clinical profile, in comparison with HB sAg serum levels. HB crAg was retrospectively assessed on serum samples from a population of treatment‐naive HB eAg‐negative patients by ChemiLuminescent Enzyme Immunoassay ( CLEIA ). HB sAg and HBV ‐ DNA data were collected. Serological data were associated to clinical profile, defined in the subsequent follow‐up of at least 1 year. In the overall population of 160 HB eAg‐negative patients, HB crAg results weakly correlated with qHBsA g levels (Spearman r = 0.471, P < 0.0001) and correlated closely with HBV ‐ DNA (Spearman r = 0.746, P < 0.0001). HB crAg 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 HB sAg levels. In long‐term clinical evaluation, a single measurement of HB crAg at the established cut‐off was optimally consistent with clinical outcome. Conversely, the HB sAg cut‐off performed well in the true quiescent phase and less in more difficult‐to‐categorize patients. In conclusion, single‐point use of HB crAg serum levels provides an accurate identification of CIB and represents a useful tool for patient classification.