Anti-HBc IgG Levels: A Predictor of HBsAg Seroclearance in Chronic Hepatitis B Patients with Nucleos(t)ide Analogue-Induced HBeAg Seroclearance

Dig Dis Sci. 2022 Jan;67(1):321-328. doi: 10.1007/s10620-021-06845-2. Epub 2021 Jan 30.

Abstract

Background/aims: We investigated the efficiency of the indirect ratio of anti-HBc IgG at predicting HBsAg seroclearance in patients with nucleos(t)ide analogue (NA)-induced HBeAg seroclearance.

Methods: We performed a retrospective study that included 366 chronic hepatitis B patients (March 2007 to December 2016) at a single tertiary hospital. These patients were HBsAg seropositive, and experienced NA-induced HBeAg seroclearance. The indirect ratio of light absorbance of anti-HBc IgG levels were measured with chemiluminescent microparticle immunoassay using the Architect Anti-HBc assay (Abbott Laboratories, IL, USA) as a qualitative method prior to antiviral therapy. We calculated the cumulative incidences of HBsAg seroclearance based on the anti-HBc IgG levels.

Results: After a 10-year follow-up, 48 patients experienced HBsAg seroclearance (13.1%). Thirty-three of 179 patients who had an indirect ratio of light absorbance of anti-HBc IgG < 11 RLU (relative light unit) showed HBsAg seroclearance (18.4%); 15 of 187 patients who had an indirect ratio of light absorbance of anti-HBc IgG ≥ 11 RLU showed HBsAg seroclerance (8.0%) (p = 0.003). In multivariate analysis, age, and ALT at the time of HBeAg seroclearance were predictors of HBsAg seroclearance. Especially, the relative risk of HBsAg seroclearance in patients with baseline anti-HBc IgG levels < 11 RLU was 2.213 (95% CI, 1.220-4.014), compared to that in patients with higher levels of anti-HBc IgG at baseline (p = 0.009).

Conclusion: Using an indirect method for anti-HBc IgG levels, baseline anti-HBc IgG levels (< 11RLU), age (≥ 50 years), and ALT (≥ 40 IU/L) might be associated with HBsAg seroclearance in patients with NA-induced HBeAg seroclearance.

Keywords: Hepatitis B core antigen; Hepatitis B e antigen; Hepatitis B surface antigen; Hepatitis B virus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antiviral Agents / therapeutic use
  • Female
  • Hepatitis B Antibodies / blood*
  • Hepatitis B Core Antigens / immunology*
  • Hepatitis B e Antigens / immunology*
  • Hepatitis B, Chronic* / drug therapy
  • Hepatitis B, Chronic* / immunology
  • Humans
  • Immunoglobulin G / blood*
  • Liver Function Tests / methods
  • Male
  • Middle Aged
  • Nucleosides / therapeutic use*
  • Prognosis
  • Retrospective Studies
  • Seroconversion / drug effects
  • Serologic Tests / methods
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Hepatitis B Antibodies
  • Hepatitis B Core Antigens
  • Hepatitis B e Antigens
  • Immunoglobulin G
  • Nucleosides