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CN 22-1108/R
Volume 41 Issue 8
Aug.  2025
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Article Navigation >  Journal of Clinical Hepatology  > 2025  >  41(8): 1556-1562

Value of quantitative hepatitis B core antibody in predicting the prognosis of decompensated hepatitis B cirrhosis patients with normal international normalized ratio

DOI: 10.12449/JCH250814
  • 1.

    Department of Gastroenterology and Hepatology，The Central Hospital of Tianjin University，Tianjin 300170，China

  • 2.

    Tianjin Third Central Hospital，Tianjin 300170，China

  • 3.

    Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases，Tianjin 300170，China

  • 4.

    Artificial Cell Engineering Technology Research Center，Tianjin 300170，China

  • 5.

    Tianjin Institute of Hepatobiliary Disease，Tianjin 300170，China

Research funding:

Science and Technology Project of Tianjin Health Commission for Special Supporting Key Disciplines (TJWJ2022XK029)

More Information
  • Corresponding author: XIANG Huiling， huilingxiang@163.com （ORCID： 0000-0003-3678-4225）
  • Received Date: 2025-02-16
  • Accepted Date: 2025-03-21
  • Published Date: 2025-08-25
    Abstract
  •   Objective  To determine the serum level of quantitative hepatitis B core antibody （qAnti-HBc） in decompensated hepatitis B cirrhosis patients with normal international normalized ratio （INR）， and to investigate its prognostic value in this target population.  Methods  A total of 120 decompensated hepatitis B cirrhosis patients with normal INR who were diagnosed and treated in Tianjin Third Central Hospital from October 1， 2018 to April 1， 2021 were enrolled. Baseline indicators were collected， the serum level of qAnti-HBc was measured， and the prognosis was followed up. According to the prognosis， the patients were divided into survival group and death group. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between groups. Univariate and multivariate Cox regression analyses were used to investigate the candidate variables affecting the prognosis and establish a prognostic model for this population， and the receiver operating characteristic （ROC） curve was plotted.  Results  The patients enrolled were followed up for 32.17±13.09 months， and there were 99 patients （82.5%） in the survival group and 21 patients （17.5%） in the death group. There were significant differences between the survival group and the death group in sex （χ2=2.151， P=0.014）， age （t=-3.218， P=0.003）， total bilirubin （Z=-0.901， P=0.027）， albumin （t=3.353， P=0.001）， and Child-Pugh class （χ2=1.144， P=0.010）. The univariate and multivariate Cox regression analyses showed that serum qAnti-HBc （hazard ratio ［HR］=0.57， 95% confidence interval ［CI］： 0.32‍ ‍—‍ ‍1.00， P=0.043）， age （HR=1.06， 95%CI：1.00‍ ‍—‍ ‍1.12， P=0.044）， sex （HR=3.82， 95%CI： 1.46‍ ‍—‍ ‍10.00， P=0.006）， platelet count （HR=0.98， 95%CI： 0.97‍ ‍—‍ ‍1.00， P=0.037）， and albumin （HR=0.86， 95%CI： 0.79‍ ‍—‍ ‍0.95， P=0.002） were independent risk predictive factors for the prognosis of decompensated hepatitis B cirrhosis patients with normal INR. Based on these factors， a predictive model was established as h（t， x）/h0（t）=exp（1.34X1+0.06X2-0.14X3-0.02X4-0.57X5）， where X1=sex， X2=age， X3=albumin， X4=platelet count， X5=qAnti-HBc. This predictive model had an area under the ROC curve of 0.842， with a sensitivity of 0.79， a specificity of 0.73， and a C-index of 0.85.  Conclusion  In decompensated hepatitis B cirrhosis patients with normal INR （0.8‍ ‍—‍ ‍1.2）， serum qAnti-HBc is one of the independent risk predictive factors for death， and the predictive model established based on the combination of serum qAnti-HBc and other indicators can effectively predict the prognosis of patients.

     

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