AUTHOR=Wu Weikang , Yuan Xiaojie , Zhang Weilu , Zhou Haowei , Kong Xiangyu , He Zhen , Fu Ting , Zhang Wenhua , Jia Wenling , Liang Chunhui , Tang Haitao , Wang Fengmei , Ye Yancheng , Shao Zhongjun , Ji Zhaohua TITLE=Clinical significance of novel biomarkers to predict the natural course of hepatitis B infection JOURNAL=Frontiers in Public Health VOLUME=10 YEAR=2022 URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.1037508 DOI=10.3389/fpubh.2022.1037508 ISSN=2296-2565 ABSTRACT=Background and aim

Chronic hepatitis B (CHB) can be divided into immune tolerance (IT), immune clearance (IC), hepatitis B e antigen (HBeAg)-negative inactive/quiescent carrier (ENQ), and HBeAg-negative hepatitis (ENH) phases. The conventional biomarkers used to distinguish these phases have limitations. We examined the clinical significance of hepatitis B virus (HBV) RNA and hepatitis B core-related antigen (HBcrAg) as novel biomarkers.

Methods

One hundred eighty-nine patients without treatment currently were categorized by CHB phase (IT = 46, IC = 45, ENQ = 49, ENH = 49). The associations of HBV RNA and HBcrAg with HBV DNA and alanine transaminase (ALT) were analyzed. The decision tree model was used to distinguish the four phases in the natural course of CHB.

Results

The concentrations of HBV RNA and HBcrAg were highest in the IT and IC phases (P < 0.01). Serum HBV RNA was similar to HBcrAg in treatment-naïve patients. HBV RNA and HBcrAg correlated with HBV DNA in the HBeAg+ and HBeAg− status (HBV RNA: e+ r = 0.51, e− r = 0.62; HBcrAg: e+ r = 0.51, e− r = 0.71), but their association with HBV DNA differed among phases. The accuracy, sensitivity, and specificity of HBcrAg with ALT in distinguishing the CHB phases were 95.65%, 95.83%, and 95.55%, respectively.

Conclusion

Serum HBV RNA and HBcrAg may be useful to monitor CHB progression.