Quantitative hepatitis B core antibody and quantitative hepatitis B surface antigen: Novel viral biomarkers for chronic hepatitis B management

Abstract

The management of hepatitis B virus (HBV) infection now involves regular and appropriate monitoring of viral activity, disease progression, and treatment response. Traditional HBV infection biomarkers are limited in their ability to predict clinical outcomes or therapeutic effectiveness. Quantitation of HBV core antibodies (qAnti-HBc) is a novel non-invasive biomarker that may help with a variety of diagnostic issues. It was shown to correlate strongly with infection stages, hepatic inflammation and fibrosis, chronic infection exacerbations, and the presence of occult infection. Furthermore, qAnti-HBc levels were shown to be predictive of spontaneous or treatment-induced HBeAg and HBsAg seroclearance, relapse after medication termination, re-infection following liver transplantation, and viral reactivation in the presence of immunosuppression. qAnti-HBc, on the other hand, cannot be relied on as a single diagnostic test to address all problems, and its diagnostic and prognostic potential may be greatly increased when paired with qHBsAg. Commercial qAnti-HBc diagnostic kits are currently not widely available. Because many methodologies are only semi-quantitative, comparing data from various studies and defining universal cut-off values remains difficult. This review focuses on the clinical utility of qAnti-HBc and qHBsAg in chronic hepatitis B management.

Keywords: Quantitative hepatitis B core antibody; Quantitative hepatitis B surface antigen; Chronic hepatitis B management; Novels viral biomarkers

Core Tip: It is possible to employ a quantitative hepatitis B virus (HBV) core antibody (qAnti-HBc) level as a predictor of therapeutic response, recurrence after hepatitis B surface antigen (HBsAg) loss, and HBsAg seroclearance. Just like other newly identified biomarkers, qAnti-HBc is not a stand-alone diagnostic test that can solve every issue. The information that is now available indicates that it may have a much higher diagnostic and prognostic effectiveness when combined with quantitative HBsAg. Further research involving larger and more variable patients is required to assess the actual usefulness of these biomarkers.