Anti-HBc: a significant host predictor of spontaneous HBsAg seroclearance in chronic hepatitis B patients - a retrospective longitudinal study

• Published in: BMC gastroenterology 2023-10, Vol.23 (1), p.1-348, Article 348
• Main Authors: Kan, Karin, Wong, Danny Ka-Ho, Hui, Rex Wan-Hin, Seto, Wai Kay, Yuen, Man-Fung, Mak, Lung-Yi
• Format: Article
• Language: English
• Subjects: Analysis; Anti-Hepatitis B core total antibodies; Antibodies; Antigens; B cells; Care and treatment; Chronic infection; Core protein; Diagnosis; Gastroenterology; Hepatitis associated antigen; Hepatitis B; Hepatitis B core antigen; Hepatitis B Surface Antigen; Hepatitis B Virus; Immune system; Infections; Liver cancer; Liver cirrhosis; Liver diseases; Longitudinal studies; Patients; Plasma; Prevention; Risk factors; Seroclearance; Statistical significance; Testing
• ISSN: 1471-230X; 1471-230X
• DOI: 10.1186/s12876-023-02983-1

Background and Aim : In chronic hepatitis B infection (CHB), seroclearance of hepatitis B surface antigen (HBsAg) is associated with favourable clinical outcomes compared to those with persistent HBsAg seropositivity, and thus considered as a desired treatment endpoint. This current study explores the possibility of serum antibody to hepatitis B core antigen (anti-HBc) as a potential predictive factor of HBsAg seroclearance. Methods This is a retrospective study that analyzed the plasma samples of CHB patients using the LUMIPULSE[R] G1200 analyzer. The longitudinal anti-HBc level between patients who subsequently achieved HBsAg seroclearance (S-losers) and those with persistent HBsAg-positivity (controls) were compared at multiple time points before the event. Results A total of 240 subjects (120 S-losers and 120 controls; age- and gender-matched) were included (mean age 56.42 [+ or -] 10.81, 65% male). Compared to controls, S-losers had significantly lower plasma anti-HBc levels prior to HBsAg seroclearance, with a significant trend of declining plasma anti-HBc 8-5 years prior to HBsAg seroclearance (p < 0.01), while such trend was not observed in controls. ROC curve analysis revealed that plasma anti-HBc at multiple time points before HBsAg seroclearance return AUC greater than 0.7. Plasma anti-HBc level at the cut-off value of 82.50 COI was 68.3% sensitive and 90% specific for HBsAg seroclearance within 1 year. Combining with quantitative HBsAg < 100 IU/mL, anti-HBc < 82.5 COI identified 88.2% patients who would develop HBsAg seroclearance within 1 year. Conclusion Plasma anti-HBc level began to decline 10 years prior to HBsAg seroclearance and can serve as a potential predictor for subsequent HBsAg seroclearance. Keywords: Hepatitis B Virus, Hepatitis B Surface Antigen, Seroclearance, Hepatitis B core antigen, Anti-Hepatitis B core total antibodies