Role of quantitative hepatitis B core antibody levels in predicting significant liver inflammation in chronic hepatitis B patients with normal or near‐normal alanine aminotransferase levels
Aim Chronic hepatitis B (CHB) patients with normal alanine aminotransferase (ALT) levels are not free from significant hepatic lesions. Recently, there has been an improved understanding of the clinical significance of quantitative hepatitis B core antibody levels (qAnti‐HBc) during CHB management....
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| Veröffentlicht in: | Hepatology research 2018-02, Vol.48 (3), p.E133-E145 |
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| creator | Li, Jing Zhang, Tian‐Ying Song, Liu‐Wei Qi, Xun Yu, Xue‐Ping Li, Fa‐Hong Zhou, Pu Qin, Yan‐Li Yang, Lin Zhao, Jing‐Hua Mao, Ri‐Cheng Zhang, Yong‐Mei Wang, Jin‐Yu Yang, Fei‐Fei Zhu, Hao‐Xiang Yang, Si‐Si Huang, Yu‐Xian Yuan, Quan Zhang, Jun Zhang, Ji‐Ming Xia, Ning‐Shao |
| description | Aim
Chronic hepatitis B (CHB) patients with normal alanine aminotransferase (ALT) levels are not free from significant hepatic lesions. Recently, there has been an improved understanding of the clinical significance of quantitative hepatitis B core antibody levels (qAnti‐HBc) during CHB management. In this cross‐sectional study, we evaluated the utility of qAnti‐HBc in identifying significant liver inflammation in CHB patients.
Methods
A total of 469 patients (training set, n = 363; validation set, n = 106) who underwent liver biopsy (LB) were included. The qAnti‐HBc levels were quantified and the relationship between histology and serum markers was systematically analyzed.
Results
In the training set, qAnti‐HBc levels were found to have significant diagnostic value for moderate to severe liver inflammation (≥G2) in all patients (area under the receiver operating characteristic curve [AUROC] = 0.768; 95% confidence interval [CI], 0.721–0.810; P |
| doi_str_mv | 10.1111/hepr.12937 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1920203505</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1920203505</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4177-755686b1779fb77620532c60092e753a7f547552ade06cccb3aadba8e57375023</originalsourceid><addsrcrecordid>eNp9kc9qFTEUh4Motl7d-AAScCPC1PyZmcwstVQrFJSi4G7IZM70pmSS2yTTcnd9hL6R7-KT9EzvVdCF2eSQ8-XjBz9CXnJ2xPG8W8MmHnHRSvWIHPJGiYLJ8sdjnGVTF7Us6wPyLKVLxrhionxKDkSjmFKqOSQ_z4MDGkZ6NWufbdbZXgNFIw7ZJvqBmhCBLrs-DFvq4BpcotbTTYTBmmz9BU32wtvRGqSow_8R96PT04SS4BfYrGPw1vwlXibwOdEbm9fUhzhpR0OkHnT8dXu3f9BOe-sxwWR9yFH7NELUCfZJnpMno3YJXuzvFfn-8eTb8Wlx9uXT5-P3Z4UpuVKFqqq6qXsc27FXqhasksLUjLUCVCW1GqsSGaEHYLUxppdaD71uoFJSVUzIFXmz825iuJoh5W6yyYDDdBDm1PFWMMFkhd4Vef0Pehnm6DEdUm3bqLaVJVJvd5SJIaUIY7eJdtJx23HWLbV2S63dQ60Iv9or536C4Q_6u0cE-A64sQ62_1F1pydfz3fSe-BksqA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1999879934</pqid></control><display><type>article</type><title>Role of quantitative hepatitis B core antibody levels in predicting significant liver inflammation in chronic hepatitis B patients with normal or near‐normal alanine aminotransferase levels</title><source>Access via Wiley Online Library</source><creator>Li, Jing ; Zhang, Tian‐Ying ; Song, Liu‐Wei ; Qi, Xun ; Yu, Xue‐Ping ; Li, Fa‐Hong ; Zhou, Pu ; Qin, Yan‐Li ; Yang, Lin ; Zhao, Jing‐Hua ; Mao, Ri‐Cheng ; Zhang, Yong‐Mei ; Wang, Jin‐Yu ; Yang, Fei‐Fei ; Zhu, Hao‐Xiang ; Yang, Si‐Si ; Huang, Yu‐Xian ; Yuan, Quan ; Zhang, Jun ; Zhang, Ji‐Ming ; Xia, Ning‐Shao</creator><creatorcontrib>Li, Jing ; Zhang, Tian‐Ying ; Song, Liu‐Wei ; Qi, Xun ; Yu, Xue‐Ping ; Li, Fa‐Hong ; Zhou, Pu ; Qin, Yan‐Li ; Yang, Lin ; Zhao, Jing‐Hua ; Mao, Ri‐Cheng ; Zhang, Yong‐Mei ; Wang, Jin‐Yu ; Yang, Fei‐Fei ; Zhu, Hao‐Xiang ; Yang, Si‐Si ; Huang, Yu‐Xian ; Yuan, Quan ; Zhang, Jun ; Zhang, Ji‐Ming ; Xia, Ning‐Shao</creatorcontrib><description>Aim
Chronic hepatitis B (CHB) patients with normal alanine aminotransferase (ALT) levels are not free from significant hepatic lesions. Recently, there has been an improved understanding of the clinical significance of quantitative hepatitis B core antibody levels (qAnti‐HBc) during CHB management. In this cross‐sectional study, we evaluated the utility of qAnti‐HBc in identifying significant liver inflammation in CHB patients.
Methods
A total of 469 patients (training set, n = 363; validation set, n = 106) who underwent liver biopsy (LB) were included. The qAnti‐HBc levels were quantified and the relationship between histology and serum markers was systematically analyzed.
Results
In the training set, qAnti‐HBc levels were found to have significant diagnostic value for moderate to severe liver inflammation (≥G2) in all patients (area under the receiver operating characteristic curve [AUROC] = 0.768; 95% confidence interval [CI], 0.721–0.810; P < 0.001) and in patients with normal or near‐normal ALT levels (AUROC = 0.767; 95% CI, 0.697–0.828; P < 0.001). Our novel index (AC index) for the identification of ≥G2 inflammation, which combined the qAnti‐HBc and ALT levels, significantly improved diagnostic performance (AUROC = 0.813; 95% CI, 0.768–0.852) compared to the use of ALT alone (AUROC = 0.779; 95% CI, 0.732–0.821) in all patients. In the validation set, the AC index showed an improved AUROC of 0.890 (95% CI, 0.814–0.942) and 0.867 (95% CI, 0.749–0.943) in all patients and patients with normal ALT levels, respectively.
Conclusions
The qAnti‐HBc level predicts significant liver inflammation well, even in patients with normal or near‐normal ALT levels. Compared with the conventional ALT level, the AC index is a more reliable non‐invasive biomarker for significant liver inflammation in CHB patients.</description><identifier>ISSN: 1386-6346</identifier><identifier>EISSN: 1872-034X</identifier><identifier>DOI: 10.1111/hepr.12937</identifier><identifier>PMID: 28707778</identifier><language>eng</language><publisher>Netherlands: Wiley Subscription Services, Inc</publisher><subject>Alanine ; Alanine transaminase ; Biopsy ; chronic HBV infection ; Hepatitis ; Hepatitis B ; hepatitis B virus ; Inflammation ; Interferon ; Liver ; non‐invasive marker ; quantitative anti‐HBc</subject><ispartof>Hepatology research, 2018-02, Vol.48 (3), p.E133-E145</ispartof><rights>2017 The Japan Society of Hepatology</rights><rights>2017 The Japan Society of Hepatology.</rights><rights>2018 The Japan Society of Hepatology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4177-755686b1779fb77620532c60092e753a7f547552ade06cccb3aadba8e57375023</citedby><cites>FETCH-LOGICAL-c4177-755686b1779fb77620532c60092e753a7f547552ade06cccb3aadba8e57375023</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fhepr.12937$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fhepr.12937$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,45579,45580</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28707778$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, Jing</creatorcontrib><creatorcontrib>Zhang, Tian‐Ying</creatorcontrib><creatorcontrib>Song, Liu‐Wei</creatorcontrib><creatorcontrib>Qi, Xun</creatorcontrib><creatorcontrib>Yu, Xue‐Ping</creatorcontrib><creatorcontrib>Li, Fa‐Hong</creatorcontrib><creatorcontrib>Zhou, Pu</creatorcontrib><creatorcontrib>Qin, Yan‐Li</creatorcontrib><creatorcontrib>Yang, Lin</creatorcontrib><creatorcontrib>Zhao, Jing‐Hua</creatorcontrib><creatorcontrib>Mao, Ri‐Cheng</creatorcontrib><creatorcontrib>Zhang, Yong‐Mei</creatorcontrib><creatorcontrib>Wang, Jin‐Yu</creatorcontrib><creatorcontrib>Yang, Fei‐Fei</creatorcontrib><creatorcontrib>Zhu, Hao‐Xiang</creatorcontrib><creatorcontrib>Yang, Si‐Si</creatorcontrib><creatorcontrib>Huang, Yu‐Xian</creatorcontrib><creatorcontrib>Yuan, Quan</creatorcontrib><creatorcontrib>Zhang, Jun</creatorcontrib><creatorcontrib>Zhang, Ji‐Ming</creatorcontrib><creatorcontrib>Xia, Ning‐Shao</creatorcontrib><title>Role of quantitative hepatitis B core antibody levels in predicting significant liver inflammation in chronic hepatitis B patients with normal or near‐normal alanine aminotransferase levels</title><title>Hepatology research</title><addtitle>Hepatol Res</addtitle><description>Aim
Chronic hepatitis B (CHB) patients with normal alanine aminotransferase (ALT) levels are not free from significant hepatic lesions. Recently, there has been an improved understanding of the clinical significance of quantitative hepatitis B core antibody levels (qAnti‐HBc) during CHB management. In this cross‐sectional study, we evaluated the utility of qAnti‐HBc in identifying significant liver inflammation in CHB patients.
Methods
A total of 469 patients (training set, n = 363; validation set, n = 106) who underwent liver biopsy (LB) were included. The qAnti‐HBc levels were quantified and the relationship between histology and serum markers was systematically analyzed.
Results
In the training set, qAnti‐HBc levels were found to have significant diagnostic value for moderate to severe liver inflammation (≥G2) in all patients (area under the receiver operating characteristic curve [AUROC] = 0.768; 95% confidence interval [CI], 0.721–0.810; P < 0.001) and in patients with normal or near‐normal ALT levels (AUROC = 0.767; 95% CI, 0.697–0.828; P < 0.001). Our novel index (AC index) for the identification of ≥G2 inflammation, which combined the qAnti‐HBc and ALT levels, significantly improved diagnostic performance (AUROC = 0.813; 95% CI, 0.768–0.852) compared to the use of ALT alone (AUROC = 0.779; 95% CI, 0.732–0.821) in all patients. In the validation set, the AC index showed an improved AUROC of 0.890 (95% CI, 0.814–0.942) and 0.867 (95% CI, 0.749–0.943) in all patients and patients with normal ALT levels, respectively.
Conclusions
The qAnti‐HBc level predicts significant liver inflammation well, even in patients with normal or near‐normal ALT levels. Compared with the conventional ALT level, the AC index is a more reliable non‐invasive biomarker for significant liver inflammation in CHB patients.</description><subject>Alanine</subject><subject>Alanine transaminase</subject><subject>Biopsy</subject><subject>chronic HBV infection</subject><subject>Hepatitis</subject><subject>Hepatitis B</subject><subject>hepatitis B virus</subject><subject>Inflammation</subject><subject>Interferon</subject><subject>Liver</subject><subject>non‐invasive marker</subject><subject>quantitative anti‐HBc</subject><issn>1386-6346</issn><issn>1872-034X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9kc9qFTEUh4Motl7d-AAScCPC1PyZmcwstVQrFJSi4G7IZM70pmSS2yTTcnd9hL6R7-KT9EzvVdCF2eSQ8-XjBz9CXnJ2xPG8W8MmHnHRSvWIHPJGiYLJ8sdjnGVTF7Us6wPyLKVLxrhionxKDkSjmFKqOSQ_z4MDGkZ6NWufbdbZXgNFIw7ZJvqBmhCBLrs-DFvq4BpcotbTTYTBmmz9BU32wtvRGqSow_8R96PT04SS4BfYrGPw1vwlXibwOdEbm9fUhzhpR0OkHnT8dXu3f9BOe-sxwWR9yFH7NELUCfZJnpMno3YJXuzvFfn-8eTb8Wlx9uXT5-P3Z4UpuVKFqqq6qXsc27FXqhasksLUjLUCVCW1GqsSGaEHYLUxppdaD71uoFJSVUzIFXmz825iuJoh5W6yyYDDdBDm1PFWMMFkhd4Vef0Pehnm6DEdUm3bqLaVJVJvd5SJIaUIY7eJdtJx23HWLbV2S63dQ60Iv9or536C4Q_6u0cE-A64sQ62_1F1pydfz3fSe-BksqA</recordid><startdate>201802</startdate><enddate>201802</enddate><creator>Li, Jing</creator><creator>Zhang, Tian‐Ying</creator><creator>Song, Liu‐Wei</creator><creator>Qi, Xun</creator><creator>Yu, Xue‐Ping</creator><creator>Li, Fa‐Hong</creator><creator>Zhou, Pu</creator><creator>Qin, Yan‐Li</creator><creator>Yang, Lin</creator><creator>Zhao, Jing‐Hua</creator><creator>Mao, Ri‐Cheng</creator><creator>Zhang, Yong‐Mei</creator><creator>Wang, Jin‐Yu</creator><creator>Yang, Fei‐Fei</creator><creator>Zhu, Hao‐Xiang</creator><creator>Yang, Si‐Si</creator><creator>Huang, Yu‐Xian</creator><creator>Yuan, Quan</creator><creator>Zhang, Jun</creator><creator>Zhang, Ji‐Ming</creator><creator>Xia, Ning‐Shao</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TM</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>201802</creationdate><title>Role of quantitative hepatitis B core antibody levels in predicting significant liver inflammation in chronic hepatitis B patients with normal or near‐normal alanine aminotransferase levels</title><author>Li, Jing ; Zhang, Tian‐Ying ; Song, Liu‐Wei ; Qi, Xun ; Yu, Xue‐Ping ; Li, Fa‐Hong ; Zhou, Pu ; Qin, Yan‐Li ; Yang, Lin ; Zhao, Jing‐Hua ; Mao, Ri‐Cheng ; Zhang, Yong‐Mei ; Wang, Jin‐Yu ; Yang, Fei‐Fei ; Zhu, Hao‐Xiang ; Yang, Si‐Si ; Huang, Yu‐Xian ; Yuan, Quan ; Zhang, Jun ; Zhang, Ji‐Ming ; Xia, Ning‐Shao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4177-755686b1779fb77620532c60092e753a7f547552ade06cccb3aadba8e57375023</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Alanine</topic><topic>Alanine transaminase</topic><topic>Biopsy</topic><topic>chronic HBV infection</topic><topic>Hepatitis</topic><topic>Hepatitis B</topic><topic>hepatitis B virus</topic><topic>Inflammation</topic><topic>Interferon</topic><topic>Liver</topic><topic>non‐invasive marker</topic><topic>quantitative anti‐HBc</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Jing</creatorcontrib><creatorcontrib>Zhang, Tian‐Ying</creatorcontrib><creatorcontrib>Song, Liu‐Wei</creatorcontrib><creatorcontrib>Qi, Xun</creatorcontrib><creatorcontrib>Yu, Xue‐Ping</creatorcontrib><creatorcontrib>Li, Fa‐Hong</creatorcontrib><creatorcontrib>Zhou, Pu</creatorcontrib><creatorcontrib>Qin, Yan‐Li</creatorcontrib><creatorcontrib>Yang, Lin</creatorcontrib><creatorcontrib>Zhao, Jing‐Hua</creatorcontrib><creatorcontrib>Mao, Ri‐Cheng</creatorcontrib><creatorcontrib>Zhang, Yong‐Mei</creatorcontrib><creatorcontrib>Wang, Jin‐Yu</creatorcontrib><creatorcontrib>Yang, Fei‐Fei</creatorcontrib><creatorcontrib>Zhu, Hao‐Xiang</creatorcontrib><creatorcontrib>Yang, Si‐Si</creatorcontrib><creatorcontrib>Huang, Yu‐Xian</creatorcontrib><creatorcontrib>Yuan, Quan</creatorcontrib><creatorcontrib>Zhang, Jun</creatorcontrib><creatorcontrib>Zhang, Ji‐Ming</creatorcontrib><creatorcontrib>Xia, Ning‐Shao</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Hepatology research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Jing</au><au>Zhang, Tian‐Ying</au><au>Song, Liu‐Wei</au><au>Qi, Xun</au><au>Yu, Xue‐Ping</au><au>Li, Fa‐Hong</au><au>Zhou, Pu</au><au>Qin, Yan‐Li</au><au>Yang, Lin</au><au>Zhao, Jing‐Hua</au><au>Mao, Ri‐Cheng</au><au>Zhang, Yong‐Mei</au><au>Wang, Jin‐Yu</au><au>Yang, Fei‐Fei</au><au>Zhu, Hao‐Xiang</au><au>Yang, Si‐Si</au><au>Huang, Yu‐Xian</au><au>Yuan, Quan</au><au>Zhang, Jun</au><au>Zhang, Ji‐Ming</au><au>Xia, Ning‐Shao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Role of quantitative hepatitis B core antibody levels in predicting significant liver inflammation in chronic hepatitis B patients with normal or near‐normal alanine aminotransferase levels</atitle><jtitle>Hepatology research</jtitle><addtitle>Hepatol Res</addtitle><date>2018-02</date><risdate>2018</risdate><volume>48</volume><issue>3</issue><spage>E133</spage><epage>E145</epage><pages>E133-E145</pages><issn>1386-6346</issn><eissn>1872-034X</eissn><abstract>Aim
Chronic hepatitis B (CHB) patients with normal alanine aminotransferase (ALT) levels are not free from significant hepatic lesions. Recently, there has been an improved understanding of the clinical significance of quantitative hepatitis B core antibody levels (qAnti‐HBc) during CHB management. In this cross‐sectional study, we evaluated the utility of qAnti‐HBc in identifying significant liver inflammation in CHB patients.
Methods
A total of 469 patients (training set, n = 363; validation set, n = 106) who underwent liver biopsy (LB) were included. The qAnti‐HBc levels were quantified and the relationship between histology and serum markers was systematically analyzed.
Results
In the training set, qAnti‐HBc levels were found to have significant diagnostic value for moderate to severe liver inflammation (≥G2) in all patients (area under the receiver operating characteristic curve [AUROC] = 0.768; 95% confidence interval [CI], 0.721–0.810; P < 0.001) and in patients with normal or near‐normal ALT levels (AUROC = 0.767; 95% CI, 0.697–0.828; P < 0.001). Our novel index (AC index) for the identification of ≥G2 inflammation, which combined the qAnti‐HBc and ALT levels, significantly improved diagnostic performance (AUROC = 0.813; 95% CI, 0.768–0.852) compared to the use of ALT alone (AUROC = 0.779; 95% CI, 0.732–0.821) in all patients. In the validation set, the AC index showed an improved AUROC of 0.890 (95% CI, 0.814–0.942) and 0.867 (95% CI, 0.749–0.943) in all patients and patients with normal ALT levels, respectively.
Conclusions
The qAnti‐HBc level predicts significant liver inflammation well, even in patients with normal or near‐normal ALT levels. Compared with the conventional ALT level, the AC index is a more reliable non‐invasive biomarker for significant liver inflammation in CHB patients.</abstract><cop>Netherlands</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28707778</pmid><doi>10.1111/hepr.12937</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Alanine Alanine transaminase Biopsy chronic HBV infection Hepatitis Hepatitis B hepatitis B virus Inflammation Interferon Liver non‐invasive marker quantitative anti‐HBc |
| title | Role of quantitative hepatitis B core antibody levels in predicting significant liver inflammation in chronic hepatitis B patients with normal or near‐normal alanine aminotransferase levels |
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