Combination of quantitative hepatitis B core antibody (qHBcAb) and aspartate aminotransferase (AST) can accurately diagnose immune tolerance of chronic hepatitis B virus infection based on liver biopsy - 11/11/21
pages | 11 |
Iconographies | 5 |
Vidéos | 0 |
Autres | 0 |
Highlights |
• | The combination of qHBcAb and AST can well diagnose the immune tolerance period of hepatitis B. |
• | The qHBcAb, a non-invasive index, can better reflect the inflammation and fibrosis of liver histopathology. |
• | Normal ALT, high HBV DNA and positive HBeAg do not mean that hepatitis B patients must be in the stage of immune tolerance. |
Abstract |
Background and aims |
Immune tolerance is defined as HBeAg positive, high hepatitis B virus load (HBV), persistent normal alanine aminotransferase (ALT), no or slight inflammation or fibrosis in liver histology. However, it is still unclear the threshold of high hepatitis B virus load and how to predict histology without liver biopsy. The aim of this study was to predict immune tolerance in HBeAg positive, alanine aminotransferase -normal populations with non-invasive indicators.
Methods |
Two multi-center prospective cohort study recruited 907 treatment-naïve chronic hepatitis B (CHB) patients who had undergone liver biopsy in mainland China from August 2013 to September 2016 and April 2018 to June2019. Quantitative hepatitis B core antibody, AST and HBV DNA were investigated using commercial diagnostic assays and histological grading and staging was assessed by the Ishak scoring system.
Results |
One hundred and thirteen untreated CHB patients with HBeAg-positive, normal alanine aminotransferase (ALT) and high level of HBV DNA (≥5log10 IU/mL) were enrolled in this study. The area under the receiver operating characteristic curves (AUROCs) of qHBcAb, AST, HBV DNA and qHBcAb-AST index were 79.6%, 80.5%, 76.4% and 87.7%. Our novel qHBcAb-AST index, which combined qHBcAb and AST showed better performance with higher sensitivity (88.6% [95% confidence interval (CI) 72.3% – 96.3%]) and negative predictive value (NPV) (93.8% [95% CI 84.2% - 98.0%]).
Conclusions |
The combination of qHBcAb and AST can more accurately predict the immune tolerance of people with HBeAg-positive, normal alanine aminotransferase (ALT).
Le texte complet de cet article est disponible en PDF.Abbreviations : AASLD, EASL, BMI, HBsAg, qHBcAb, ALT, ULN, AST, ALP, GGT, ALB, Tbil, AFP, WBC, PLT, LSM, C5a, C3like1, IP10, IL-2R, ITAC, A2M, HP, HA, LN, PIIINP, ANGPTL2, APRI, FIB-4, HAI, F, AUROC, LLoD
Keywords : Hepatitis B, Immune tolerance, Non-Invasive marker, Diagnose
Plan
Vol 45 - N° 6
Article 101563- novembre 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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