Su Xi, Chen Huangping, Zhu Zifei, Xie Wanying, Peng Jianqiao, Ma Xinping, Jin Wenwen, Shi Wei, Deng Zhonghua, Li Cunyan
Department of Laboratory Medicine, Hunan Provincial People's Hospital (The First-affiliated Hospital of Hunan Normal University), Changsha 410005, China.
Research Office of Clinical Laboratory, Clinical Translational Medicine Research Institute of Hunan Provincial People's Hospital (The First-affiliated Hospital of Hunan Normal University), Changsha 410005, China.
Bioinorg Chem Appl. 2021 Nov 22;2021:3720571. doi: 10.1155/2021/3720571. eCollection 2021.
The level of CHB virus (HBV) core antibody (HBcAb) is different in four stages of chronic HBV infection and may be used for differential diagnosis of the natural history of chronic HBV infection. To address this question, we examined multiple blood biomarkers and assessed the efficacy to diagnose different stages of chronic HBV infection. The quantitative detection of HBcAb, hepatitis B surface antigen (HBsAg), HBV DNA, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and platelet count (PLT) were determined in the serum of 73 cases of low-replicative phase (LR), 46 cases of immune-tolerant phase (IT), 44 cases of immune clearance phase (IC), and 57 cases of HBeAg-negative hepatitis (ENH). Differentiating performance of these serum protein levels was analyzed by receiver operating characteristic (ROC) curve analysis. Our results showed that the levels of HBcAb, ALT, and AST levels were significantly higher in IC and ENH than those in LR and IT (both ≤ 0.001). The levels of HBV DNA and HBsAg were higher in IC and IT than those in LR and ENH (both ≤ 0.001). Logistic regression models showed that HBcAb, HBsAg, HBV DNA, ALT, and AST were the independent variables, respectively, and when combined, they provided high diagnostic accuracy for the staging of CHB. To sum up, HBcAb quantification is a new index, which can reflect whether the liver is in the immune activation state of HBV infection, and is related to the inflammatory state of the host liver. The combined detection of HBcAb quantification and other indicators has showed promising efficiency for staging of IC and ENH and can assist the diagnosis and treatment of CHB.
慢性乙型肝炎病毒(HBV)核心抗体(HBcAb)水平在慢性HBV感染的四个阶段有所不同,可用于慢性HBV感染自然史的鉴别诊断。为解决这一问题,我们检测了多种血液生物标志物,并评估了诊断慢性HBV感染不同阶段的效能。对73例低复制期(LR)、46例免疫耐受期(IT)、44例免疫清除期(IC)和57例HBeAg阴性肝炎(ENH)患者的血清进行HBcAb、乙型肝炎表面抗原(HBsAg)、HBV DNA、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)和血小板计数(PLT)的定量检测。通过受试者工作特征(ROC)曲线分析来分析这些血清蛋白水平的鉴别性能。我们的结果显示,IC期和ENH期的HBcAb、ALT和AST水平显著高于LR期和IT期(均P≤0.001)。IC期和IT期的HBV DNA和HBsAg水平高于LR期和ENH期(均P≤0.001)。逻辑回归模型显示,HBcAb、HBsAg、HBV DNA、ALT和AST分别为独立变量,联合使用时对慢性乙型肝炎的分期具有较高的诊断准确性。综上所述,HBcAb定量是一项新指标,可反映肝脏是否处于HBV感染的免疫激活状态,并与宿主肝脏的炎症状态相关。HBcAb定量与其他指标的联合检测对IC期和ENH期的分期显示出良好的效能,可辅助慢性乙型肝炎的诊断和治疗。