Value of serum hepatitis B virus core-related antigen in predicting the treatment outcome of HBeAg-positive chronic hepatitis B patients treated with pegylated interferon-α

Objective To investigate the value of hepatitis B virus core-related antigen (HBcrAg) in predicting the treatment outcome of HBeAg-positive chronic hepatitis B (CHB) patients treated with pegylated interferon-α (PEG-IFNα) . Methods A total of 79 HBeAg-positive CHB patients who were treated with PEG-IFNα in Department of Infectious Diseases in The Affiliated Hospital of Xuzhou Medical University from May 2012 to June 2015 were enrolled. The course of treatment was 48 weeks, and the patients were followed up for at least 24 weeks after treatment. HBcrAg, HBV serum markers, HBV DNA, and alanine aminotransferase (ALT) level were measured before treatment and at weeks 12, 24, and 48 of treatment. The t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between groups; a Pearson correlation analysis was performed to investigate correlation; a binary logistic regression analysis was used to identify the influencing factors for complete response; the receiver operating characteristic (ROC) curve was used to investigate the value of HBcrAg in predicting complete response. Results Among the 79 HBeAg-positive CHB patients who were treated with PEG-IFNα antiviral therapy and then followed up for 24 weeks, 35 achieved complete response. Compared with the non-response group, the response group had a significantly lower baseline HBs Ag level (P = 0. 008) , HBeAg level (P < 0. 001) , and HBcrAg level (P = 0. 002) . Baseline HBcrAg was positively correlated with HBV DNA (r = 0. 325, P =0. 003) , HBs Ag level (r = 0. 468, P < 0. 001) , and HBeAg level (r = 0. 695, P < 0. 001) and was not correlated with ALT level. Serum HBcrAg tended to decrease during treatment, and at week 12 of treatment, the response group had a significantly greater reduction in HBcrAg level compared with the non-response group (Z =-2. 653, P = 0. 008) . HBcrAg level at week 12 of treatment was an independent risk factor for complete response (odds ratio = 5. 510, 95% confidence interval: 1. 656-18. 326, P < 0. 05) . The optimal cut-off value of serum HBcrAg was 6. 45 log10 U/ml, and the area under the ROC curve was 0. 845. Conclusion HBcrAg is correlated with HBs Ag, HBeAg, and HBV DNA before PEG-IFNα antiviral therapy. Serum HBcrAg level at week 12 of treatment can be used to predict complete response after PEG-IFNα treatment.