Hepatitis B core-related antigen serum levels may be a predictor of acute flare of chronic hepatitis B among pregnant women in the immune-tolerant phase of chronic HBV infection after short-course antiviral therapy
Ruyu Liu,
Liu Yang,
Tingting Jiang,
Yao Lu,
Lu Zhang,
Ge Shen,
Shuling Wu,
Min Chang,
Hongxiao Hao,
Leiping Hu,
Yuanjiao Gao,
Mengjiao Xu,
Xiaoxue Chen,
Wei Yi,
Minghui Li,
Yao Xie
Affiliations
Ruyu Liu
Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
Liu Yang
Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
Tingting Jiang
Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
Yao Lu
Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
Lu Zhang
Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
Ge Shen
Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
Shuling Wu
Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
Min Chang
Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
Hongxiao Hao
Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
Leiping Hu
Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
Yuanjiao Gao
Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
Mengjiao Xu
Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
Xiaoxue Chen
Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
Wei Yi
Department of Obstetrics and gynecology, Beijing Ditan Hospital, Capital Medical University, Beijing, China
Minghui Li
Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
Yao Xie
Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
ABSTRACTBackground Studies have shown acute flares of chronic hepatitis B (CHB) might be related to immunologic changes that occur during pregnancy. However, the indicators for predicting acute flares of CHB among pregnant women still need further study. We aimed to distinguish the relevance between serum levels of HBcrAg and acute flares of CHB in pregnant women in the immune-tolerant phase of chronic HBV infection after short-course antiviral therapy.Methods A total of 172 chronic HBV-infected pregnant women who were judged to be in the immune-tolerant phase were recruited in our research. All patients received short-course antiviral therapy with TDF. The biochemical, serological, and virological parameters were measured using standard laboratory procedures. The serum levels of HBcrAg were tested by ELISA.Results Fifty-two (30.2%) out of 172 patients had acute flares of CHB. At postpartum week 12 (TDF cessation), serum HBcrAg (OR, 4.52; 95% CI, 2.58–7.92) and HBsAg (OR, 2.52; 95% CI, 1.13–5.65) were associated with acute flares of CHB. The serum HBcrAg levels were beneficial for confirmation of patients with acute flares of CHB, with an area under the ROC curve of 0.84 (95% CI, 0.78–0.91).Conclusions For pregnant women with chronic HBV infection in the immune-tolerant phase, serum HBcrAg and HBsAg levels at postpartum week 12 were associated with acute flares of CHB after short-course antiviral therapy with TDF. The serum HBcrAg level can correctly identify acute flares of CHB and may be a predictor of the need for continuing antiviral therapy after 12 weeks postpartum.
