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Clinical implications of hepatitis B surface antigen quantitation in the natural history of chronic hepatitis B virus infection
Zhaoxia Tan a, c,
Maoshi Li a, c, 1,
Xuemei Kuang a, c,
Yu Tang a, c,
Yi Fan a, c,
Guohong Deng a, c,
Yuming Wang a, c,
Dengming He a, b, c, Corresponding author contact information, E-mail the corresponding author
Corresponding author at: Institute of Infectious Disease, Southwest Hospital, Third Military Medical University, China. Tel.: +86 23 68754485.
1
Contributed equally to this work.
http://dx.doi.org/10.1016/j.jcv.2014.01.013
Abstract
Background
HBsAg quantitation may be useful for managing patients with hepatitis B virus (HBV) infection.
Objectives
We explored the clinical implications of HBsAg quantitation for patients with HBsAg levels >250 IU/ml (Abbott Diagnostics).
Study design
Two 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 conclusions
HBsAg (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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