Association of anti‐HBc and liver inflammation in HBeAg‐negative chronic hepatitis B virus‐infected patients with normal ALT and detectable HBV DNA

Abstract Serum hepatitis B core antibody (anti‐HBc) is associated with liver inflammation in chronic hepatitis B patients. This study aimed to investigate whether anti‐HBc could serve as a predictor of significant liver inflammation in hepatitis B e antigen (HBeAg)‐negative chronic hepatitis B virus (HBV) infected patients with normal alanine aminotransferase (ALT) and detectable HBV DNA. Treatment‐naïve HBeAg‐negative chronic HBV infected patients with normal ALT and detectable HBV DNA who underwent liver biopsy were retrospectively included from two medical centers. Liver inflammation grade was evaluated using the Scheuer scoring system and significant liver inflammation was defined as ≥G2. Serum anti‐HBc levels were measured by commercial immunoassays (Abbott GmbH & Co. KG). A total of 117 patients were included and 50 (42.7%) patients showed significant liver inflammation. Serum anti‐HBc levels in patients with significant liver inflammation were significantly higher than patients with no or mild liver inflammation (<G2) ( p < 0.001). High serum anti‐HBc (odds ratio 1.562, 95% confidential interval 1.157–2.110, p = 0.004) was an independent risk factor of significant liver inflammation. The area under the receiver operating characteristic curve of serum anti‐HBc in predicting significant liver inflammation was 0.769 and the optimal cut‐off value was 10.87 S/CO, with a sensitivity of 59.2% and a specificity of 87.9%. Our data revealed that a substantial of HBeAg‐negative chronic infection patients with normal ALT and detectable HBV DNA showed significant liver inflammation. Serum anti‐HBc can predict significant liver inflammation in these patients.