Guide
Several hepatitis B virus (HBV) serum markers have been identified as risk factors for liver fibrosis in patients with chronic HBV infection, and some noninvasive tests based on serum markers are now being used to identify the severity of liver fibrosis in patients. The objective of this study was to determine the relationship between serum levels of core-associated antigen (HBcrAg) and liver fibrosis in patients with hepatitis B core-associated antigen (HBcrAg) in patients with initial treatment of chronic HBV infection, as well as other indicators associated with hepatic fibrosis.
Research methodology
A total of 246 patients with chronic HBV infection were included in this study. All patients underwent liver biopsy at baseline. The METAVIR score was used for liver fibrosis staging, and 15, 140, 50, 26, and 15 patients were in stages F0, F1, F2, F3, and F4, respectively. Biochemical, serological, and virological parameters are measured using standard laboratory procedures. HBcrAg serum levels in patients are measured by ELISA.
Research results
Serum HBcrAg levels were significantly higher in patients with stages F2, F3, and F4 compared with patients without significant liver fibrosis (METAVIR scores F0-F1), but there were no significant differences between patients with stages F2, F3, and F4.
serum HBcrAg (OR, 2.18; 95% CI, 1.51-3.16), albumin (ALB) (OR, 0.60; 95% CI, 0.41-0.87), prothrombin activity (PTA) (OR, 0.58; 95% CI, 0.40-0.83), and platelet (PLT) count (OR, 0.38; 95% CI, 0.25-0.57) was associated with significant hepatic fibrosis (METAVIR score F2-F4 stages) (Table 1).
Table 1 Logistic regression analyzes the correlation between liver fibrosis and various indicators
*p＜0.01
PLT and PTA in the significant hepatic fibrosis group were significantly reduced. As the stage of liver fibrosis increases, PLT decreases significantly (Figure 1A). Patients with stage F3 and F4 had significantly reduced PTA compared with the group without significant liver fibrosis (Figure 1C). Compared with the group without significant liver fibrosis, there was a decreasing trend in ALP in patients with stageS F2, F3, and F4, but there was no statistically significant difference between these four groups (Figure 1B).
Fig. 1 PLT count and ALP and PTA levels in patients with different stages
Serum HBcrAg levels accurately identify patients with significant hepatic fibrosis, with a subject area under the working characteristic curve (AUROC) of 0.81 (95% CI, 0.75-0.88). Significant liver fibrosis was identified by APRI, FIB-4 index, and ALBI score, with areas under the ROC curve being 0.74 (95% CI, 0.66-0.81), 0.73 (95% CI, 0.65-0.80), and 0.63 (95% CI, 0.55-0.72), respectively. Compared with these three indicators, the accuracy of identifying significant hepatic fibrosis based on HBcrAg levels was higher than that of the FIB-4 index (p=0.0479) and the ALBI score (p=0.0030).
Conclusions of the study
In this study, serum HBcrAg, ALB, PTA levels, and PLT counts were associated with significant hepatic fibrosis in patients with initial treatment of chronic HBV infection. Serum HBcrAg levels accurately identify patients with significant hepatic fibrosis (METAVIR score F2-F4 stage), and HBcrAg levels are more effective than FIB-4 index and ALBI score.
参考文献：Liu R, Li M, Lu Y, et al. Hepatitis B core-related antigen serum levels are associated with significant liver fibrosis in treatment-naive chronic HBV infection patients[J]. J Viral Hepat. 2022 Mar 31. doi: 10.1111/jvh.13674.