Clinical Diagnostic Value of Quantitative Hepatitis B Virus Core Antibody Test in Chronic Viral Hepatitis B

The level of CHB virus (HBV) core antibody (HBcAb) is different in four stages of chronic HBV infection and may be used for differential diagnosis of the natural history of chronic HBV infection. To address this question, we examined multiple blood biomarkers and assessed the efficacy to diagnose different stages of chronic HBV infection. The quantitative detection of HBcAb, hepatitis B surface antigen (HBsAg), HBV DNA, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and platelet count (PLT) were determined in the serum of 73 cases of low-replicative phase (LR), 46 cases of immune-tolerant phase (IT), 44 cases of immune clearance phase (IC), and 57 cases of HBeAg-negative hepatitis (ENH). Differentiating performance of these serum protein levels was analyzed by receiver operating characteristic (ROC) curve analysis. Our results showed that the levels of HBcAb, ALT, and AST levels were significantly higher in IC and ENH than those in LR and IT (both P ≤ 0.001 ). The levels of HBV DNA and HBsAg were higher in IC and IT than those in LR and ENH (both P ≤ 0.001 ). Logistic regression models showed that HBcAb, HBsAg, HBV DNA, ALT, and AST were the independent variables, respectively, and when combined, they provided high diagnostic accuracy for the staging of CHB. To sum up, HBcAb quantification is a new index, which can reflect whether the liver is in the immune activation state of HBV infection, and is related to the inflammatory state of the host liver. The combined detection of HBcAb quantification and other indicators has showed promising efficiency for staging of IC and ENH and can assist the diagnosis and treatment of CHB.

Download Full-text

Quantitative HBsAg versus HBV DNA in Predicting Significant Hepatitis Activity of HBeAg-Positive Chronic HBV Infection

Journal of Clinical Medicine ◽

10.3390/jcm10235617 ◽

2021 ◽

Vol 10 (23) ◽

pp. 5617

Author(s):

Zhanqing Zhang ◽

Wei Lu ◽

Dong Zeng ◽

Dan Huang ◽

Weijia Lin ◽

...

Keyword(s):

Hepatitis B ◽

Hepatitis B Surface Antigen ◽

Hbv Dna ◽

Hbv Infection ◽

Chronic Hbv Infection ◽

Hbv Replication ◽

Regression Curves ◽

Chronic Hepatitis B Virus ◽

Positive Chronic Hepatitis ◽

Chronic Hbv

(1) Background: As specialparameters in predicting significant hepatitis activity of hepatitis B e antigen (HBeAg)-positive chronic hepatitis B virus (HBV) infection, the quantitative standard of HBV DNA has not been agreed and that of hepatitis B surface antigen(HBsAg) has not been formed. Our objective is to evaluate the validity of HBsAg and HBV DNA in predicting the significant hepatitis activity of HBeAg-positive patients. (2) Methods: A population of 516 patients with HBeAg-positive chronic HBV infection was enrolled. Serum ALT was measured using an Abbott Architect c16000 autoanalyzer; diagnoses of liver pathological grade and stage referred to the Scheuer standard. Three levels of significant hepatitis activity were preset, which were successively “ALT ≥ 20 IU/L or Grade > G1 or Stage > S1”, “ALT ≥ 30 IU/L or Grade > G1 or Stage > S1” and “ALT ≥ 40 IU/L or Grade > G1 or Stage > S1”. (3) Results: A subpopulation of 288 patients with possible high HBV replication was selected based on locally weighted scatterplot smoothing regression curves between ALT and HBsAg, HBeAg and HBV DNA. In the subpopulation with possible high HBV replication, areas under receiver operating characteristic curves of HBsAg for predicting the three levels of significant hepatitis activity were successively 0.868, 0.839 and 0.789, which were all significantly greater than those of HBV DNA, as those were successively 0.553, 0.550 and 0.574 (p = 0.0002, p < 0.0001 and p < 0.0001). With the standard of HBsAg ≤ 4.699 log10 IU/mL, the sensitivity and specificity of HBsAg for predicting the three levels of significant hepatitis activity were successively 75.81% and 81.82%, 79.23% and 78.57% and 80.82% and 67.44%. (4) Conclusion: Quantitative HBsAg instead of HBV DNA is valuable in predicting significant hepatitis activity of HBeAg-positive chronic HBV infection.

Download Full-text

Spectrum of Hepatits B Infection Among Patients Attending Liver Unit in Nepalgunj Medical College – Kohalpur

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v16i2.24801 ◽

2018 ◽

Vol 16 (2) ◽

pp. 2-5

Author(s):

Dipendra Khadka ◽

Sudhamshu KC ◽

Niyanta Karki ◽

Sandip Khadka ◽

Kiran Regmi

Keyword(s):

Liver Disease ◽

Hepatitis B ◽

Tertiary Care ◽

Hbv Dna ◽

Hbv Infection ◽

Hepatitis B Infection ◽

Chronic Hbv Infection ◽

Medical College ◽

Liver Unit ◽

Chronic Hbv

Introduction: Hepatitis B infection is a global problem. Hepatitis B virus (HBV) infection related liver disease is also not an uncommon problem in our country too. Reports regarding pattern of chronic HBV infection are also lacking. The aim of the present study was to determine the spectrum of chronic HBV infection among patients attending the liver clinic in a tertiary care center. Method: A hospital based descriptive cross-sectional study was carried out in Liver unit of Nepalgunj Medical College, Kohalpur, from April 2018 to November 2018. All patients with HBsAg positive were further tested for HBeAg, HBeAb, HBV DNA quantitative and liver function test. Ultrasound examination was advised for any evidence of chronic liver disease. Staging was done according to viral serology, liver biochemistry and ultrasonography of liver Results: Total patients enrolled were 119. Majority of patents were in between 30-60 years (51.3%) with male predominance 59.7%. Most of patients were in the stage of HBeAg negative chronic infection 66.4% with normal transaminase and HBV DNA <2000 IU/ML. Majority of patients having unknown source of infection 90.8%. Incidental detection (67.2%) was common mode of detection. Conclusions: Majority of patients were in HBeAg negative chronic hepatitis B infection phase with normal transaminase and low HBV DNA not requiring treatment.

Download Full-text

Kinetics of hepatitis B surface antigen quasispecies during REP 2139‐Ca therapy in HBeAg‐positive chronic HBV infection

Journal of Viral Hepatitis ◽

10.1111/jvh.13180 ◽

2019 ◽

Vol 26 (12) ◽

pp. 1454-1464 ◽

Cited By ~ 4

Author(s):

Zainab Usman ◽

Hrvoje Mijočević ◽

Hadi Karimzadeh ◽

Martin Däumer ◽

Mamun Al‐Mathab ◽

...

Keyword(s):

Hepatitis B ◽

Surface Antigen ◽

Hepatitis B Surface Antigen ◽

Hbv Infection ◽

Chronic Hbv Infection ◽

Chronic Hbv ◽

Kinetics Of

Download Full-text

Transaminase Elevations during Treatment of Chronic Hepatitis B Infection: Safety Considerations and Role in Achieving Functional Cure

Viruses ◽

10.3390/v13050745 ◽

2021 ◽

Vol 13 (5) ◽

pp. 745

Author(s):

Andrew Vaillant

Keyword(s):

Hepatitis B ◽

Hepatitis B Surface Antigen ◽

Normal Liver ◽

Hbv Infection ◽

Functional Cure ◽

Chronic Hbv Infection ◽

New Therapies ◽

Current Therapies ◽

Chronic Hbv ◽

Safety Considerations

While current therapies for chronic HBV infection work well to control viremia and stop the progression of liver disease, the preferred outcome of therapy is the restoration of immune control of HBV infection, allowing therapy to be removed while maintaining effective suppression of infection and reversal of liver damage. This “functional cure” of chronic HBV infection is characterized by the absence of detectable viremia (HBV DNA) and antigenemia (HBsAg) and normal liver function and is the goal of new therapies in development. Functional cure requires removal of the ability of infected cells in the liver to produce the hepatitis B surface antigen. The increased observation of transaminase elevations with new therapies makes understanding the safety and therapeutic impact of these flares an increasingly important issue. This review examines the factors driving the appearance of transaminase elevations during therapy of chronic HBV infection and the interplay of these factors in assessing the safety and beneficial nature of these flares.

Download Full-text

HBsAg level as a predictor of disease activity in patients with chronic hepatitis B infection with delta-agent

Infekcionnye bolezni ◽

10.20953/1729-9225-2020-4-149-152 ◽

2020 ◽

Vol 18 (4) ◽

pp. 149-152

Author(s):

M.A. Abdukadyrova ◽

◽

S.M. Sharapov ◽

A.S. Khikmatullaeva ◽

◽

...

Keyword(s):

Liver Cirrhosis ◽

Chronic Hepatitis ◽

Hepatitis B ◽

Disease Activity ◽

Chronic Hepatitis B ◽

Hbv Dna ◽

Hbv Infection ◽

Hbsag Level ◽

Chronic Hbv Infection ◽

Chronic Hbv

We have conducted a pilot study to identify the association between the HBsAg level and activity of the pathological process in the liver, as well as possibility of quantitative assessment of HBsAg for monitoring chronic liver diseases caused by hepatitis B virus (HBV) and hepatitis D virus (HDV). Objective. To assess the possibility of using HBsAg levels as a predictor of disease activity and prognosis in patients with chronic HBV infection with delta-agent. Patients and methods. We analyzed serum specimens from 30 patients with HDV and HBV co-infection. Among 15 patients with chronic hepatitis B with delta-agent, there were 5 HBV DNA positive and 10 HBV DNA negative. Among patients with liver cirrhosis, HBV DNA was detected in 11 individuals, while 4 individuals had undetectable HBV DNA levels. Results. We found that mean HBsAg level in patients with chronic HBV infection and negative HBV DNA was 1.9 ± 0.56 IU/mL. Mean HBsAg level in patients with chronic HBV infection with delta-agent and positive HBV DNA was 4.3 ± 0.62 IU/mL (p < 0.05). High HBsAg levels correlated with elevated ALT in patients with chronic hepatitis B and delta-agent. Patients with liver cirrhosis caused by HDV had normal ALT levels, but elevated bilirubin concentrations regardless of HBV DNA presence and HBsAg level. Conclusion. High levels of HBsAg can be considered as a predictor of active disease in patients with chronic HBV infection with delta-agent and also a marker of transformation of chronic hepatitis B with delta-agent into liver cirrhosis. Key words: chronic hepatitis B with delta agent, liver cirrhosis, enzyme-linked immunosorbent assay, HBsAg levels, polymerase chain reaction

Download Full-text

Immune modulator and antiviral potential of dendritic cells pulsed with both hepatitis B surface antigen and core antigen for treating chronic HBV infection

Antiviral Therapy ◽

10.3851/imp1637 ◽

2010 ◽

Vol 15 (6) ◽

pp. 887-895 ◽

Cited By ~ 19

Author(s):

Sheikh Mohammad Fazle Akbar ◽

Osamu Yoshida ◽

Shiyi Chen ◽

Aguilar Julio Cesar ◽

Masanori Abe ◽

...

Keyword(s):

Dendritic Cells ◽

Hepatitis B ◽

Surface Antigen ◽

Hepatitis B Surface Antigen ◽

Hbv Infection ◽

Core Antigen ◽

Chronic Hbv Infection ◽

Immune Modulator ◽

Chronic Hbv

Download Full-text

Serum Hepatitis B Virus (HBV)DNA Levels at Different Stages of Clinical Course in Patients with Chronic HBV Infection in an Endemic Area

Journal of Korean Medical Science ◽

10.3346/jkms.2003.18.5.686 ◽

2003 ◽

Vol 18 (5) ◽

pp. 686 ◽

Cited By ~ 9

Author(s):

Jeong Heo ◽

Tae Hyun Baik ◽

Hyung Hoi Kim ◽

Gwang Ha Kim ◽

Dae Hwan Kang ◽

...

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Endemic Area ◽

Clinical Course ◽

Hbv Dna ◽

Hbv Infection ◽

Serum Hepatitis ◽

Chronic Hbv Infection ◽

B Virus ◽

Chronic Hbv

Download Full-text

China Registry of Hepatitis B (CR-HepB): Protocol and implementation of a nationwide hospital-based registry of hepatitis B

Scandinavian Journal of Public Health ◽

10.1177/1403494818772188 ◽

2018 ◽

Vol 48 (2) ◽

pp. 233-239 ◽

Cited By ~ 1

Author(s):

Shan Shan ◽

Wei Wei ◽

Yuanyuan Kong ◽

Junqi Niu ◽

Jia Shang ◽

...

Keyword(s):

Hepatitis B ◽

Real World ◽

Hepatitis B Surface Antigen ◽

Data Entry ◽

Standard Of Care ◽

Hbv Infection ◽

Chronic Hbv Infection ◽

Treatment Information ◽

Radiology Reports ◽

Chronic Hbv

Aims: The disease burden of chronic HBV infection in China remains high, although the rate of new infections has become extremely low. To facilitate real-world clinical study of chronic HBV infection, we established a nationwide hospital-based electronic platform, named the China Registry of Hepatitis B (CR-HepB). Methods: This internet-based registry for chronic hepatitis B recruited patients from tertiary or secondary hospitals that have particular interest and expertise in managing hepatitis B patients. The main inclusion criteria for the database were men or women with hepatitis B surface antigen positivity ≥ 6 months, hepatitis B e antigen positive or negative, with or without cirrhosis, and with or without treatment. At the first time of data entry, demographics, medical history, virology, biochemistry, hematology and radiology reports, as well as diagnosis and treatment information, are recorded. Registered patients then receive a standard of care and follow-up every three (optional) to six months (required) for changes in virology, biochemistry and radiology, as well as clinical progression. Results and Conclusions: To date, 47 hospitals have joined the CR-HepB. This platform can be used to demonstrate the clinical pattern and treatment profile of chronic HBV infection, evaluate long-term efficacy and safety of antiviral therapy and provide real-world evidence for policy-making in China. Trial registration: ClinicalTrials.gov ID: NCT03108794

Download Full-text

Absence of Hepatitis B Resistance Mutants before Introduction of Oral Antiviral Therapy

ISRN Hepatology ◽

10.1155/2013/130384 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Martin Moehlen ◽

Maria De Medina ◽

Mary Hill ◽

Lennox Jeffers ◽

Eugene R. Schiff ◽

...

Keyword(s):

Hepatitis B ◽

Antiviral Therapy ◽

Hbv Dna ◽

Hbv Infection ◽

Drug Resistant ◽

Induced Mutations ◽

Resistance Mutations ◽

Chronic Hbv Infection ◽

Treatment Naïve ◽

Chronic Hbv

Introduction. The aim of this study was to assess whether hepatitis B virus drug resistant mutations antedated the widespread use of nucleos(t)ide analogues in treatment naïve patients. A number of reports have suggested that drug resistant mutants can be detected in apparently treatment naïve patients. Study. Fifty deidentified serum samples collected from 1986 to 1992 from patients with replicative chronic HBV infection at the University of Miami were genotyped and tested for resistance mutations using a line probe assay InnoLiPA HBV DR v2/v3. Serum HBV DNA was measured. All patients had documented chronic HBV infection with a detectable viral load, HBeAg seropositivity, and absence of HIV infection. Results. Of the 50 individuals included, 86% were male, mean age was 40 ± 12 years, and mostly genotype A. The mean HBV DNA was 126 pg/mL (range 6.4 to 557.0). No mutations were identified. Conclusions. The absence of drug induced mutations in these sera collected several years prior to the introduction of oral antiviral therapy suggests that these mutations do not occur in treatment naïve populations. Detection of drug resistance in an apparently treatment naïve subject suggests either unrecognized prior antiviral therapy or infection by an inoculum from a treatment experienced patient.

Download Full-text