Anti-HBc IgM associates with acute flare and HBeAg/HBsAg loss in chronic hepatitis B patients with acute exacerbation

Acute exacerbation (AE) is common for patients with chronic hepatitis B (CHB). The aim of the study is to investigate the values of hepatitis B core antibody (anti-HBc) IgM in CHB-AE. Patients were screened from a prospective sub-cohort, 419 CHB patients with AE were enrolled and divided into groups...

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Main Authors: Ying Zhang, Ying Zhu, Yi Zhou, Zhaoxia Tan, Yunjie Dan, Xin Zou, Guohong Deng, Wenting Tan
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Virulence
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Online Access:https://www.tandfonline.com/doi/10.1080/21505594.2025.2534078
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author Ying Zhang
Ying Zhu
Yi Zhou
Zhaoxia Tan
Yunjie Dan
Xin Zou
Guohong Deng
Wenting Tan
author_facet Ying Zhang
Ying Zhu
Yi Zhou
Zhaoxia Tan
Yunjie Dan
Xin Zou
Guohong Deng
Wenting Tan
author_sort Ying Zhang
collection DOAJ
description Acute exacerbation (AE) is common for patients with chronic hepatitis B (CHB). The aim of the study is to investigate the values of hepatitis B core antibody (anti-HBc) IgM in CHB-AE. Patients were screened from a prospective sub-cohort, 419 CHB patients with AE were enrolled and divided into groups according to antiviral treatment history, treatment naïve, withdrawal above or within 6 months, and on-treatment. The prevalence, clinical characteristics of anti-HBc IgM, and its relationship with the outcomes of CHB were assessed. A total of 157 patients (37.5%) were tested positive for anti-HBc IgM, of which patients with antiviral-withdrawal more than 6 months had the highest prevalence (49.3%). Anti-HBc IgM was significantly associated with HBV DNA and ALT, regarding to its prevalence and serum level. Furthermore, serum anti-HBc IgM values varied in different phases of CHB, of which immune active and HBeAg-negative chronic hepatitis phases were significantly higher than that in inactive carriers (p = 0.017 and p = 0.0097, respectively). Anti-HBc IgM could distinguish hepatitis from inactive infection phases in HBeAg-negative patients (AUC 0.841). Anti-HBc IgM levels were significantly higher in subgroup who developed ACLF (p < 0.05), but had no relationship with short-term mortality. Finally, anti-HBc IgM seropositivity was the only predictor of HBeAg seroclearance (OR 3.18, 95% CI 1.30–7.73) and all patients who achieved HBsAg seroclearance within 1-year had a markedly elevated anti-HBc IgM level. In conclusion, our study shows anti-HBc IgM is highly prevalent in CHB patients with AE and would be a new predictor of HBeAg and HBsAg loss in this population.
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spelling doaj-art-fdc8a594134f469c8666d27ad129434e2025-08-20T02:40:51ZengTaylor & Francis GroupVirulence2150-55942150-56082025-12-0116110.1080/21505594.2025.2534078Anti-HBc IgM associates with acute flare and HBeAg/HBsAg loss in chronic hepatitis B patients with acute exacerbationYing Zhang0Ying Zhu1Yi Zhou2Zhaoxia Tan3Yunjie Dan4Xin Zou5Guohong Deng6Wenting Tan7Department of Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, ChinaDepartment of Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, ChinaDepartment of Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, ChinaDepartment of Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, ChinaDepartment of Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, ChinaDepartment of Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, ChinaDepartment of Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, ChinaDepartment of Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing, ChinaAcute exacerbation (AE) is common for patients with chronic hepatitis B (CHB). The aim of the study is to investigate the values of hepatitis B core antibody (anti-HBc) IgM in CHB-AE. Patients were screened from a prospective sub-cohort, 419 CHB patients with AE were enrolled and divided into groups according to antiviral treatment history, treatment naïve, withdrawal above or within 6 months, and on-treatment. The prevalence, clinical characteristics of anti-HBc IgM, and its relationship with the outcomes of CHB were assessed. A total of 157 patients (37.5%) were tested positive for anti-HBc IgM, of which patients with antiviral-withdrawal more than 6 months had the highest prevalence (49.3%). Anti-HBc IgM was significantly associated with HBV DNA and ALT, regarding to its prevalence and serum level. Furthermore, serum anti-HBc IgM values varied in different phases of CHB, of which immune active and HBeAg-negative chronic hepatitis phases were significantly higher than that in inactive carriers (p = 0.017 and p = 0.0097, respectively). Anti-HBc IgM could distinguish hepatitis from inactive infection phases in HBeAg-negative patients (AUC 0.841). Anti-HBc IgM levels were significantly higher in subgroup who developed ACLF (p < 0.05), but had no relationship with short-term mortality. Finally, anti-HBc IgM seropositivity was the only predictor of HBeAg seroclearance (OR 3.18, 95% CI 1.30–7.73) and all patients who achieved HBsAg seroclearance within 1-year had a markedly elevated anti-HBc IgM level. In conclusion, our study shows anti-HBc IgM is highly prevalent in CHB patients with AE and would be a new predictor of HBeAg and HBsAg loss in this population.https://www.tandfonline.com/doi/10.1080/21505594.2025.2534078Chronic hepatitis Bacute exacerbationanti-HBc IgMhepatitis flareseroclearance
spellingShingle Ying Zhang
Ying Zhu
Yi Zhou
Zhaoxia Tan
Yunjie Dan
Xin Zou
Guohong Deng
Wenting Tan
Anti-HBc IgM associates with acute flare and HBeAg/HBsAg loss in chronic hepatitis B patients with acute exacerbation
Virulence
Chronic hepatitis B
acute exacerbation
anti-HBc IgM
hepatitis flare
seroclearance
title Anti-HBc IgM associates with acute flare and HBeAg/HBsAg loss in chronic hepatitis B patients with acute exacerbation
title_full Anti-HBc IgM associates with acute flare and HBeAg/HBsAg loss in chronic hepatitis B patients with acute exacerbation
title_fullStr Anti-HBc IgM associates with acute flare and HBeAg/HBsAg loss in chronic hepatitis B patients with acute exacerbation
title_full_unstemmed Anti-HBc IgM associates with acute flare and HBeAg/HBsAg loss in chronic hepatitis B patients with acute exacerbation
title_short Anti-HBc IgM associates with acute flare and HBeAg/HBsAg loss in chronic hepatitis B patients with acute exacerbation
title_sort anti hbc igm associates with acute flare and hbeag hbsag loss in chronic hepatitis b patients with acute exacerbation
topic Chronic hepatitis B
acute exacerbation
anti-HBc IgM
hepatitis flare
seroclearance
url https://www.tandfonline.com/doi/10.1080/21505594.2025.2534078
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