ACE Score Identifies HBeAg-negative Inactive Carriers at a Single-point Evaluation, Regardless of HBV Genotype
Roade, Luisa (Universitat Autònoma de Barcelona. Departament de Bioquímica i de Biologia Molecular)
Riveiro Barciela, Mar (Universitat Autònoma de Barcelona. Departament de Bioquímica i de Biologia Molecular)
Palom, Adriana (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
Rodríguez Frías, Francisco (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Bes, Marta (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Rando-Segura, Ariadna (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Salcedo, Maria-Teresa (Hospital Universitari Vall d'Hebron)
Casillas, Rosario (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Vargas-Accarino, Elena (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Tabernero, David (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Sauleda, Silvia (Banc de Sang i Teixits (Barcelona, Catalunya))
Esteban, Rafael (Hospital Universitari Vall d'Hebron)
Buti, Maria (Hospital Universitari Vall d'Hebron)

Date:	2022
Abstract:	Hepatitis B virus (HBV) biomarkers have been used for a better categorization of patients, even though the lack of simple algorithms and the impact of genotypes limit their application. Our aim was to assess the usefulness of noninvasive markers for the identification of HBV inactive carriers (ICs) in a single-point evaluation and to design a predictive model for their identification. This retrospective-prospective study included 343 consecutive HBeAg-negative individuals. Clinical, analytical, and virological data were collected, and a liver biopsy was performed if needed. Subjects were classified at the end of follow-up as ICs, chronic hepatitis B and gray zone. A predictive model was constructed, and validated by 1000-bootstrap samples. After 39 months of follow-up, 298 subjects were ICs, 36 were chronic hepatitis B CHB, and nine were gray zone. Eighty-nine (25. 9%) individuals required a liver biopsy. Baseline HBV DNA hazard ratio (HR) 6. 0, p <0. 001), HBV core-related antigen (HBcrAg) (HR 6. 5, p <0. 001), and elastography (HR 4. 6, p <0. 001) were independently associated with the IC stage. The ACE score (HBV DNA, HBcrAg, elastography), obtained by bootstrapping, yielded an area under the receiver operating characteristics (AUROC) of 0. 925 (95% CI: 0. 880-0. 970, p <0. 001) for identification of ICs. The AUROC for genotype D was 0. 95, 0. 96 for A, 0. 90 for E, and 0. 88 for H/F. An ACE score of <1 had a positive predictive value of 99. 5%, and a score ≤12 points had a diagnostic accuracy of 93. 8%. Low baseline HBV DNA, HBcrAg, and liver stiffness were independently associated with the IC phase. A score including those variables identified ICs at a single-point evaluation, and might be applied to implement less intensive follow-up strategies.
Grants:	Instituto de Salud Carlos III PI17/02233 Instituto de Salud Carlos III PI20/01692
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Hepatitis B virus ; Inactive carrier ; Liver stiffness ; HBV DNA ; Quantitative HBsAg ; Core-related antigen
Published in:	Journal of Clinical and Translational Hepatology, Vol. 10 (april 2022) , p. 1068-1076, ISSN 2310-8819

DOI: 10.14218/JCTH.2022.00068
PMID: 36381089

9 p, 1.4 MB

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