Clinical significance of serum HBsAg levels and association with liver histology in HBeAg positive chronic hepatitis B

Cheng, Pin-Nan; Tsai, Hung‐Wen; Chiu, Yen-Cheng; Ho, Cheng-Hsun; Wu, I‐Chin; Chang, Ting‐Tsung

doi:10.1016/j.jcv.2013.04.012

Cited by 16 publications

(12 citation statements)

References 25 publications

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“…Quite recently, the relationship between serum HBsAg and liver histology has been discussed [9]–[12]. In the present study, a positive correlation between serum HBsAg and HBV DNA load was revealed in the treatment-naïve HBeAg(+) CHB patients.…”

Section: Discussionsupporting

confidence: 61%

Enhanced HBsAg Synthesis Correlates with Increased Severity of Fibrosis in Chronic Hepatitis B Patients

et al. 2014

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Background and AimsLittle is known about whether low serum HBsAg levels result from impaired HBsAg synthesis or a reduced number of hepatocytes caused by advanced liver fibrosis. Therefore, we investigated the capacity for HBsAg synthesis in a cross-sectional cohort of treatment-naïve chronic hepatitis B patients.MethodsChronic hepatitis B patients (n = 362) were enrolled; liver biopsies were performed and liver histology was scored, and serum HBsAg and HBV DNA levels were investigated. In the enrolled patients, 183 out of 362 have quantitative serum HBsAg levels. Tissue HBsAg was determined by immunohistochemistry.ResultsA positive correlation between serum HBsAg and HBV DNA levels was revealed in HBeAg(+) patients (r = 0.2613, p = 0.0050). In HBeAg(+) patients, serum HBsAg and severity of fibrosis were inversely correlated (p = 0.0094), whereas tissue HBsAg levels correlated positively with the stage of fibrosis (p = 0.0280). After applying the mean aminopyrine breath test as a correction factor, adjusted serum HBsAg showed a strong positive correlation with fibrosis severity in HBeAg(+) patients (r = 0.5655, p<0.0001). The adjusted serum HBsAg values predicted ‘moderate to severe’ fibrosis with nearly perfect performance in both HBeAg(+) patients (area under the curve: 0.994, 95% CI: 0.983–1.000) and HBeAg(−) patients (area under the curve: 1.000, 95% CI: 1.000–1.000).ConclusionsAlthough serum HBsAg levels were negatively correlated with fibrosis severity in HBeAg(+) patients, aminopyrine breath test-adjusted serum HBsAg and tissue HBsAg, two indices that are unaffected by the number of residual hepatocytes, were positively correlated with fibrosis severity. Furthermore, adjusted serum HBsAg has an accurate prediction capability.

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Section: Discussionsupporting

confidence: 61%

Enhanced HBsAg Synthesis Correlates with Increased Severity of Fibrosis in Chronic Hepatitis B Patients

et al. 2014

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“…In this study, there is statistically significant positive correlation among all studied groups between HBsAg quantitation and fibrosis (P= 0.018). This is in agreement with Cheng et al who had concluded that the correlation between advanced liver fibrosis and HBsAg level was a significant [28].…”

Section: Discussionsupporting

confidence: 93%

Correlation between HBsAg Quantitation Assay, Histopathology and Viral - DNA Level in Chronic HBV Patients

Mostafa

El-Shewi

El-Raouf

et al. 2015

Afro-Egyptian Journal of Infectious and Endemic Diseases

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Results: A significant correlation between serum HBsAg quantitation level and HBV DNA levels was revealed in all studied HBeAg negative patients (r =0.748, P= <0.001). A significant correlation between serum HBsAg level and fibrosis (r=0.334, P= 0.018). While, there is no significant correlation between serum HBsAg quantitation level and activity by Metaver scoring in all studied patients (P >0.05). Conclusion: All the studied patients were tested for assess correlation between HBsAg quantitation, HBV-DNA level and histopathology grading and staging. There is strong positive correlation between HBsAg quantation level and HBV-DNA and between HBsAg quantation level and stages of fibrosis. No correlation between HBV DNA levels and histopathology.

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“…There is emerging evidence, suggesting association between HBsAg level and liver fibrosis in HBeAgpositive patients. [23][24][25] The aim of our study was to evaluate the association of HBsAg level with biochemical, virological, and histological features in asymptomatic patients with chronic HBV infection and its ability to differentiate between different groups of chronic HBV infection.…”

Section: H Epatitis B Virus (Hbv) Infection Remains a Seriousmentioning

confidence: 99%

HBsAg Level as Predictor of Liver Fibrosis in HBeAg Positive Patients With Chronic Hepatitis B Virus Infection

Goyal

Jain

Dixit

et al. 2015

Journal of Clinical and Experimental Hepatology

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Background and aims: Preliminary data suggests lower serum hepatitis B surface antigen level is associated with more severe liver fibrosis in HBeAg positive patients. We evaluated the association of HBsAg level with biochemical, virological, and histological features in asymptomatic patients with chronic HBV infection. Methods: HBsAg levels were measured at baseline in 481 asymptomatic, treatment naive patients with chronic HBV infection. Subjects were followed-up prospectively (median, 12; range, 8-36 months). Phases of HBV infection were defined after regular monitoring of HBV-DNA and transaminases. Liver histology was scored using the METAVIR system. Results: HBeAg positive (n, 126) patients were significantly younger than HBeAg negative (n, 355), median age 26 vs 30 years; P < 0.01. HBV genotype could be determined in 350 patients, 240 (68.57%) had genotype D and 100 (28.57%) had genotype A. HBsAg level had modest correlation with serum HBV DNA(r = 0.6 vs 0.4 in eAg positive & negative respectively). HBeAg + ve patients with fibrosis score ! F2 showed significantly lower median serum HBsAg levels and serum HBV DNA levels compared with patients with F0-F1 score (median, range; 4.51, 2.99-6.10 vs 5.06, 4.13-5.89, P < 0.01) and (8.39, 3.85-10.60, P < 0.01) respectively. Significant inverse correlation of HBsAg level was found with liver fibrosis in eAg positive group (r = À0.76; P < 0.001). HBsAg level cut off value 4.7 log 10 IU/ml predicted moderate to advance fibrosis (F ! 2) with 92% sensitivity, 85% specificity & 91% negative predictive value. Conclusion: Lower HBsAg level might reflect the status of advanced liver fibrosis in HBeAg positive chronic hepatitis B subjects. ( J CLIN EXP HEPATOL 2015;5:213-220)

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Clinical significance of serum HBsAg levels and association with liver histology in HBeAg positive chronic hepatitis B

Cited by 16 publications

References 25 publications

Enhanced HBsAg Synthesis Correlates with Increased Severity of Fibrosis in Chronic Hepatitis B Patients

Enhanced HBsAg Synthesis Correlates with Increased Severity of Fibrosis in Chronic Hepatitis B Patients

Correlation between HBsAg Quantitation Assay, Histopathology and Viral - DNA Level in Chronic HBV Patients

HBsAg Level as Predictor of Liver Fibrosis in HBeAg Positive Patients With Chronic Hepatitis B Virus Infection

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