Abstract: Objective To investigate the value of semi-quantitative detection of hepatitis B core antibody (HBcAb) combined with early virological response in predicting hepatitis B envelope antigen (HBeAg) seroconversion in HBeAg-positive chronic hepatitis B (CHB) patients treated with peginterferon initially.Methods A total of 96 HBeAg-positive CHB patients in our hospital from January 2013 to January 2019 were retrospectively analyzed. All patients were initially treated with peginterferon for 48 weeks. The level of HBcAb was measured by chemiluminescent microparticle immunoassay before and during treatment every 12 weeks. Mann-Whitney U test and Kruskal-Wallis H test were used to determine intergroup differences. Receiver operating characteristic (ROC) curve was used to calculate the diagnostic value.Results Baseline HBcAb levels of patients who achieved serological response were higher (11.92, 10.07-12.80 vs 10.61, 9.49-11.47, P=0.003). Univariate logistic regression analysis showed that baseline HBcAb level (odds ratio [OR]=1.469, 95% confidence interval: 1.137-1.898, P=0.003) and achievement of early virological response (OR=3.507, 95% CI: 1.051-11.69, P=0.041) were independently related to serological response of peginterferon. Multivariate binary logistic regression analysis suggested that baseline HBcAb level (OR=1.831, 95% CI: 1.299-2.582, P=0.001) and early virological response (OR=2.161, 95% CI: 1.595-7.851, P=0.024) could predict serological response in CHB patients receiving peginterferon. The cut-off value of baseline HBcAb was 11.6 S/CO with the area under the ROC curve of 0.72 (95% CI: 0.59-0.86, P=0.004), and the diagnostic sensitivity and specificity were 73.42% and 64.71%, respectively. Patients were stratified according to the baseline HBcAb cut-off value of 11.6 S/CO and the achievement of early virological response. The HBeAg seroconversion rate at week 48 of patients who achieved early virological response with baseline HBcAb ≥ 11.6 S/CO was 42.86%. The HBeAg seroconversion rates at week 48 of patients with either baseline HBcAb ≥ 11.6 S/CO or early virological response were 18.18% (2/11) and 12.12% (4/33). And only 0.06% (2/31) achieved HBeAg seroconversion among patients with baseline HBcAb < 11.6 S/CO and without early virological response.Conclusion The semi-quantitative detection of baseline HBcAb combined with early virological response may serve as a simple and valuable predictor of serological response in HBeAg-positive CHB patients receiving peginterferon initially, guiding physicians in clinical practice.

Key words: Chronic hepatitis B, Peginterferon, Hepatitis B core antibody, Early virological response