PT  - JOURNAL ARTICLE
AU  - Rong Fan
AU  - Jian Sun
AU  - Quan Yuan
AU  - Qing Xie
AU  - Xuefan Bai
AU  - Qin Ning
AU  - Jun Cheng
AU  - Yanyan Yu
AU  - Junqi Niu
AU  - Guangfeng Shi
AU  - Hao Wang
AU  - Deming Tan
AU  - Mobin Wan
AU  - Shijun Chen
AU  - Min Xu
AU  - Xinyue Chen
AU  - Hong Tang
AU  - Jifang Sheng
AU  - Fengmin Lu
AU  - Jidong Jia
AU  - Hui Zhuang
AU  - Ningshao Xia
AU  - Jinlin Hou
TI  - Baseline quantitative hepatitis B core antibody titre alone strongly predicts HBeAg seroconversion across chronic hepatitis B patients treated with peginterferon or nucleos(t)ide analogues
AID  - 10.1136/gutjnl-2014-308546
DP  - 2016 Feb 01
TA  - Gut
PG  - 313--320
VI  - 65
IP  - 2
4099  - http://gut.bmj.com/content/65/2/313.short
4100  - http://gut.bmj.com/content/65/2/313.full
SO  - Gut2016 Feb 01; 65
AB  - Objective The investigation regarding the clinical significance of quantitative hepatitis B core antibody (anti-HBc) during chronic hepatitis B (CHB) treatment is limited. The aim of this study was to determine the performance of anti-HBc as a predictor for hepatitis B e antigen (HBeAg) seroconversion in HBeAg-positive CHB patients treated with peginterferon (Peg-IFN) or nucleos(t)ide analogues (NUCs), respectively.Design This was a retrospective cohort study consisting of 231 and 560 patients enrolled in two phase IV, multicentre, randomised, controlled trials treated with Peg-IFN or NUC-based therapy for up to 2 years, respectively. Quantitative anti-HBc evaluation was conducted for all the available samples in the two trials by using a newly developed double-sandwich anti-HBc immunoassay.Results At the end of trials, 99 (42.9%) and 137 (24.5%) patients achieved HBeAg seroconversion in the Peg-IFN and NUC cohorts, respectively. We defined 4.4 log10 IU/mL, with a maximum sum of sensitivity and specificity, as the optimal cut-off value of baseline anti-HBc level to predict HBeAg seroconversion for both Peg-IFN and NUC. Patients with baseline anti-HBc ≥4.4 log10 IU/mL and baseline HBV DNA <9 log10 copies/mL had 65.8% (50/76) and 37.1% (52/140) rates of HBeAg seroconversion in the Peg-IFN and NUC cohorts, respectively. In pooled analysis, other than treatment strategy, the baseline anti-HBc level was the best independent predictor for HBeAg seroconversion (OR 2.178; 95% CI 1.577 to 3.009; p<0.001).Conclusions Baseline anti-HBc titre is a useful predictor of Peg-IFN and NUC therapy efficacy in HBeAg-positive CHB patients, which could be used for optimising the antiviral therapy of CHB.