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Inicio Gastroenterología y Hepatología (English Edition) Quantitative HBcrAg and HBcAb versus HBsAg and HBV DNA in predicting liver fibro...
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Vol. 43. Issue 9.
Pages 526-536 (November 2020)
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Vol. 43. Issue 9.
Pages 526-536 (November 2020)
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DOI: 10.1016/j.gastre.2020.03.005
Quantitative HBcrAg and HBcAb versus HBsAg and HBV DNA in predicting liver fibrosis levels of chronic hepatitis B patients
HBcrAg y HBcAb cuantitativos versus HBsAg y ADN del VHB en la predicción de los niveles de fibrosis hepática de los pacientes con hepatitis B crónica
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Zhan-qing Zhanga,
Corresponding author
doctorzzqsphc@163.com

Corresponding author. Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center of Fudan University, Caolang Road 2901, Jinshan District, Shanghai 201508, China. Tel.: ++8621- 37990333 ext. 3245..
, Bi-sheng Shib, Wei Lua, Dan-ping Liua, Dan Huanga, Yan-ling Fengc
a Deparment of Hepatobiliary Medicine, Shanghai Public Health Clinical Center of Fudan University
b Scientific Research Center, Shanghai Public Health Clinical Center of Fudan University
c Department of Clinical Pathology, Shanghai Public Health Clinical Center of Fudan University
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Tables (4)
Table 1. Clinical, laboratory and pathological characteristics of study population.
Table 2. Difference comparisons in Spearman correlation coefficients between different HBV markers with liver pathological grade and stage.
Table 3. AUCs of investigated HBV markers for predicting significant fibrosis and cirrhosis.
Table 4. Cutoffs and corresponding diagnostic parameters of investigated HBV markers in predicting significant fibrosis and cirrhosis.
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Abstract
Objective

To evaluate the performance of the quantitative markers of hepatitis B core-related antigen (HBcrAg) and anti-hepatitis B core antigen antibodies HbcAb versus hepatitis B surface antigen (HBsAg) and hepatitis B virus DNA (HBV DNA) in predicting liver fibrosis levels in chronic hepatitis B patients.

Methods

Two hundred and fifty hepatitis B e antigen (HBeAg)-positive and 245 HBeAg-negative patients were enrolled. With reference to the Scheuer standard, stage 2 or higher and stage 4 liver disease were defined as significant fibrosis and cirrhosis, respectively. A receiver operating characteristic (ROC) curve was used to evaluate the performance of the HBV markers investigated.

Results

The areas under the ROC curves (AUCs) of HBcrAg in predicting significant fibrosis and cirrhosis in HBeAg-positive patients (0.577 and 0.700) were both close to those of HBsAg (0.617 and 0.762) (both P> 0.05). In HBeAg-negative patients (0.797 and 0.837), they were both significantly greater than those of HBV DNA (0.723 and 0.738) (P=0.0090 and P=0.0079). The AUCs of HBcAb in predicting significant fibrosis and cirrhosis in HBeAg-positive patients (0.640 and 0.665) were both close to those of HBsAg. In HBeAg-negative patients (0.570 and 0.621), they were both significantly less than those of HBcrAg (P <0.0001 and P=0.0001). Specificity in predicting significant fibrosis and sensitivity in predicting cirrhosis in HBeAg-positive patients, using a single cut-off of HBsAg ≤5,000 IU/ml, were 76.5% and 72.7%, respectively. In HBeAg-negative patients, using a single cut-off of HBcrAg>80kU/ml, they were 85.9% and 81.3%, respectively.

Conclusions

HBsAg has good performance in predicting liver fibrosis levels in HBeAg-positive and HBeAg-negative patients, and HBcrAg has very good performance in predicting liver fibrosis levels in HBeAg-negative patients.

Keywords:
Hepatitis B core-related antigen
Anti-hepatitis B core antigen antibodies
Hepatitis B surface antigen
Virological marker
Liver fibrosis
Non-invasive diagnosis
Resumen
Objetivo

Evaluar el rendimiento de los marcadores cuantitativos del antígeno central de la hepatitis B (HBcrAg) y los anticuerpos contra el antígeno central de la hepatitis B (HBcAb) frente al antígeno de superficie de la hepatitis B (HBsAg) y el ADN del virus de la hepatitis B (ADN del VHB) en la predicción de los niveles de fibrosis hepática de los pacientes con hepatitis B crónica.

Métodos

Se inscribieron 250 pacientes con HBsAg positivo y 245 pacientes con HBeAg negativo. Con referencia al estándar de Scheuer, la etapa patológica hepática 2 o superior y la etapa 4 se definieron como fibrosis y cirrosis significativas, respectivamente. Se utilizó la curva característica de funcionamiento del receptor (ROC) para evaluar el rendimiento de los marcadores del VHB investigados.

Resultados

Las áreas bajo la curva ROC (AUC) del HBcrAg en la predicción de la fibrosis y cirrosis significativa de los pacientes positivos para el HBeAg (0,577 y 0,700) fueron ambas cercanas a las del HBsAg (0,617 y 0,762) (ambas p > 0,05); de los pacientes negativos para el HBeAg (0,797 y 0,837) fueron ambas significativamente mayores que las del ADN del VHB (0,723 y 0,738) (p = 0,0090 y p = 0,0079); las AUC del HBcAb en la predicción de la fibrosis y cirrosis significativa de los pacientes positivos para el HBeAg (0,640 y 0,665) fueron ambas cercanas a las del HBsAg; de los pacientes negativos para el HBeAg (0,570 y 0,621) fueron ambas significativamente menores que las del HBcrAg (p < 0,0001 y p = 0,0001). La especificidad en la predicción de la fibrosis significativa y la sensibilidad en la predicción de la cirrosis de los pacientes positivos para el HBeAg, utilizando un solo corte de HBsAg ≤ 5.000 UI/mL fueron 76,5 y 72,7%, respectivamente; de los pacientes negativos para el HBeAg utilizando un solo corte de HBcrAg > 80 kU/mL fueron 85,9 y 81,3%, respectivamente.

Conclusiones

El HBsAg tiene un buen rendimiento en la predicción de los niveles de fibrosis hepática de los pacientes HBeAg positivos y negativos, mientras que HBcrAg tiene un muy buen rendimiento en la predicción de los niveles de fibrosis de los pacientes HBaAg negativos.

Palabras clave:
Antígeno relacionado con el núcleo de la hepatitis B
Anticuerpos contra el antígeno del núcleo de la hepatitis B
Antígeno de superficie de la hepatitis B
Marcador virológico
Fibrosis hepática
Diagnóstico no invasivo

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