The following is a summary of “Levels of Antibodies to Hepatitis B Core Antigen Are Associated With Liver Inflammation and Response to Peginterferon in Patients With Chronic Hepatitis B,” published in the January 2023 issue of Infectious Diseases by Brakenhoff, et al.

B-cell responses appeared to play a crucial role in the course of chronic hepatitis B, according to newly available research. Antibodies to the hepatitis B core antigen (anti-HBc), found in serum at varying levels depending on the stage of infection, may or may not be used to predict how well an individual would respond to antiviral medication.

Patients with chronic hepatitis B who began peginterferon (PEG-IFN) therapy de novo (n = 299; 195 HBeAg positive) or who began PEG-IFN as an add-on to an already-existing Nucleo (s)tide analog backbone (n = 91; all HBeAg positive) had their anti-HBc levels evaluated before starting treatment. In addition, analogies between anti-HBc and serum biomarkers, liver histology results, and treatment response were investigated.

They investigated 390 patients. About 72% of patients were Caucasian, and the genotypes of the hepatitis B virus (HBV) were A, B, C, and D in 24%, 9%, 16%, and 49% of cases, respectively. Anti-HBc was associated with HBV DNA, hepatitis B core-related antigen (HBcrAg), hepatitis B surface antigen (HBsAg), and HBV RNA among HBeAg-positive individuals who are not currently receiving treatment but not with alanine aminotransferase (ALT). Regardless of HBeAg status, higher anti-HBc was linked to more severe histological inflammatory activity (P< .001). Higher anti-HBc levels following de novo PEG-IFN were linked to HBeAg loss, sustained response, HBsAg drop, and HBsAg clearance (P< .050). Higher anti-HBc was linked to HBeAg loss in patients receiving additional PEG-IFN (P =.01).

Histological inflammation was correlated with serum anti-HBc concentrations. In addition, positive treatment results were linked to higher anti-HBc levels. According to these results, those who were most likely to benefit from immunomodulatory medication might be chosen using anti-HBc.

Reference: academic.oup.com/jid/article/227/1/113/6590452