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ACE Score Identifies HBeAg-negative Inactive Carriers at a Single-point Evaluation, Regardless of HBV Genotype Roade Tato, Maria Luisa Riveiro Barciela, Maria del Mar Palom Agusti, Adriana Rodríguez Frias, Francisco Bes Maijo, Marta Salcedo Allende, Maria Teresa Casillas Gomez, Rosario Vargas Accarino, Elena Tabernero Caellas, David Sauleda Oliveras, Silvia Esteban Mur, Rafael Rando Segura, Ariadna Buti Ferret, Maria Institut Català de la Salut [Roade L, Riveiro-Barciela M, Esteban R, Buti M] Unitat Hepàtica, Servei de Medicina Interna, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain. Departament de Bioquímica i Biologia Molecular, Universitat Autònoma de Barcelona, Bellaterra, Spain. [Palom A] Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain. [Rodríguez-Frías F, Rando A, Tabernero D] Departament de Bioquímica i Biologia Molecular, Universitat Autònoma de Barcelona, Bellaterra, Spain. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain. Servei d’Hepatologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Servei de Laboratoris Clínics, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Bes M, Sauleda S] Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain. Grup de Recerca de les Malalties Hepàtiques, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Transfusion Safety Laboratory, Banc de Sang i Teixits, Servei Català de la Salut, Barcelona, Spain. [Salcedo MT] Servei d’Anatomia Patològica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Casillas R] Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain. Servei d’Hepatologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Servei de Laboratoris Clínics, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Accarino E] Departament de Bioquímica i Biologia Molecular, Universitat Autònoma de Barcelona, Bellaterra, Spain. Grup de Recerca de les Malalties Hepàtiques, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain Vall d'Hebron Barcelona Hospital Campus Marcadors bioquímics Genotip Virus de l'hepatitis B ORGANISMS::Viruses::DNA Viruses::Hepadnaviridae::Orthohepadnavirus::Hepatitis B virus CHEMICALS AND DRUGS::Biological Factors::Biomarkers PHENOMENA AND PROCESSES::Genetic Phenomena::Genotype ORGANISMOS::virus::virus ADN::Hepadnaviridae::Orthohepadnavirus::virus de la hepatitis B COMPUESTOS QUÍMICOS Y DROGAS::factores biológicos::biomarcadores FENÓMENOS Y PROCESOS::fenómenos genéticos::genotipo HBV DNA; Hepatitis B virus; Inactive carrier ADN del VHB; Virus de la hepatitis B; Portador inactivo ADN del VHB; Virus de l'hepatitis B; Portador inactiu Background and Aims 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. Methods 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. Results 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%. Conclusions 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. This study received partial financial support from Instituto de Salud Carlos III (PI17/02233 and PI20/01692). 2022-12-09T09:33:59Z 2022-12-09T09:33:59Z 2022-12 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Roade L, Riveiro-Barciela M, Palom A, Rodríguez-Frías F, Bes M, Rando A, et al. ACE Score Identifies HBeAg-negative Inactive Carriers at a Single-point Evaluation, Regardless of HBV Genotype. J Clin Transl Hepatol. 2022 Dec;10(6):1068–76. 2310-8819 https://hdl.handle.net/11351/8624 10.14218/JCTH.2022.00068 36381089 000792937900001 http://hdl.handle.net/11351/8624 eng Journal of Clinical and Translational Hepatology;10(6) http://dx.doi.org/10.14218/JCTH.2022.00068 info:eu-repo/grantAgreement/ES/PE2013-2016/PI17%2F02233 info:eu-repo/grantAgreement/ES/PE2017-2020/PI20%2F01692 Attribution-NonCommercial 4.0 International http://creativecommons.org/licenses/by-nc/4.0/ info:eu-repo/semantics/openAccess application/pdf Xia & He Scientia