Clinical implications of hepatitis B surface antigen quantitation in the natural history of chronic hepatitis B virus infection |
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| Affiliation: | 1. Institute of Infectious Disease, Southwest Hospital, Third Military Medical University, China;2. Liver Disease Diagnosis and Treatment Center, The 88th Hospital of Chinese PLA, China;3. The Chongqing Key Laboratory for Research of Infectious Diseases, China;1. Department of Virology, Erasmus Medical Centre, Erasmus University Rotterdam, The Netherlands;2. School of Life Science and Technology, Institut Teknologi Bandung, Indonesia;3. Internal Medicine Department, Hasan Sadikin Hospital-Medical Faculty, Universitas Padjadjaran Bandung, Indonesia;4. Clinical Pathology Department, Hasan Sadikin Hospital-Medical Faculty, Universitas Padjadjaran Bandung, Indonesia;5. Department of General Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands;1. Neurological Department, A. Manzoni Hospital, Lecco, Italy;2. Division of Otorhinolaryngology, A. Manzoni Hospital, Lecco, Italy;3. Division of Infectious Diseases, A. Manzoni Hospital, Lecco, Italy;1. Division of Hepato-Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Centre, Kaohsiung, Taiwan;2. Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Kaohsiung, Taiwan;1. Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, Alaska;3. Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC), Anchorage, Alaska;4. Division of Gastroenterology/Liver Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts;6. Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia;1. Right to Care, South Africa;2. Faculty of Health Science, Department of Medicine, Clinical HIV Research Unit, University of Witwatersrand, South Africa;3. National Health Laboratory Services, Faculty of Health Sciences, University of the Witwatersrand, South Africa |
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| Abstract: | BackgroundHBsAg quantitation may be useful for managing patients with hepatitis B virus (HBV) infection.ObjectivesWe explored the clinical implications of HBsAg quantitation for patients with HBsAg levels >250 IU/ml (Abbott Diagnostics).Study designTwo hundred and thirty-three HBV-infected patients comprising 29 immune tolerance cases, 49 treatment-naïve HBeAg-positive chronic hepatitis B (CHB) cases, 91 inactive HBV carrier cases, and 64 treatment-naïve HBeAg-negative CHB cases were analyzed. HBsAg was quantified by the Architect HBsAg assay (Abbott Diagnostics) after a 1:500 automated dilution.Results and conclusionsHBsAg (log 10 IU/ml) was established for immune tolerance (4.50 ± 0.43), HBeAg-positive CHB (4.17 ± 0.66), inactive HBV carrier (3.32 ± 0.44), and HBeAg-negative CHB (3.23 ± 0.40); (p = 4.92 × 10−35). No significant difference was observed between inactive HBV carrier and HBeAg-negative CHB (p = 0.247). The proportions of HBsAg <2000 IU/ml for inactive HBV carrier and HBeAg-negative CHB were 51.6% and 59.3%, respectively (p = 0.341). Positive correlations between HBsAg and HBV DNA were observed for immune tolerance (p = 1.23 × 10−4) and HBeAg-positive CHB (p = 0.003), but not for HBeAg-negative CHB (p = 0.432). A negative correlation between HBsAg and age was observed for immune tolerance (p = 0.030), HBeAg-positive CHB (p = 0.016), and inactive HBV carrier (p = 0.001), but not in HBeAg-negative CHB (p = 0.249). No significant differences between HBsAg and ALT for HBeAg-positive (p = 0.338) or HBeAg-negative CHB (p = 0.564) were observed. For patients with HBsAg quantitation >250 IU/ml, HBsAg may reflect HBV DNA replication for HBeAg-positive cases. HBsAg is not a suitable marker for evaluating hepatitis activity and distinguishing between cases of HBeAg-negative CHB and inactive HBV carrier state. |
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| Keywords: | HBsAg quantitation HBV DNA Age Natural history |
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