HBsAg quantification for identification of liver disease in chronic hepatitis B virus carriers

Abstract

HBsAg levels reflect clinical stage and liver disease, and a combined quantification of HBsAg and HBV DNA may improve clinical staging.

Can quantitative hepatitis B surface antigen levels predict the severity of liver disease in genotype E Patients?

“…Our finding that patients with advanced liver disease demonstrated lower qHBsAg levels is new. This contradicts several studies reporting lower HBsAg levels in “inactive carrier” patients than in HBeAg‐negative patients with “active” chronic hepatitis B . There may be several explanations for our findings.…”

“…Low HBsAg level (<1000 IU/mL) and normal ALT predicts the “inactive carrier” CHB phase in genotype B, C and D patients . In contrast, the majority of our cohort had HBsAg levels >1000 IU/mL and had ALT >30 IU/L (60.2%; Figure A), suggesting that they have an “active” HBeAg‐negative CHB.…”

Hepatitis B virus core‐related antigen as a surrogate marker for covalently closed circular DNA

“…The possibility of HBsAg synthesized from integrated HBV DNA may also weaken the correlation. The weak correlation between HBsAg and cccDNA has also been reported in previous studies . Thus HBsAg is not a good marker for cccDNA.…”

“…Quantitative serum HBsAg, another common marker, has been suggested to be an additional viral marker for the monitoring of disease progress . However, the correlation between HBsAg and intrahepatic HBV DNA levels varies between studies . Quantitative serum HBV RNA is another relatively novel serum marker which reflects disease activity or predicts serological response .…”

Can serum level of HBsAg differentiate HBeAg-negative chronic hepatitis B from inactive carrier state?

“…There was no correlation between HBsAg level and liver inflammation and fibrosis in the present study. In the study by Larsson et al (2014), both HBV DNA and HBsAg quantification tests had moderate sensitivities and poor PPVs (27% and 16%) for identifying patients with severe liver inflammation. This prediction improved to 33% when HBsAg and HBV DNA quantification were combined.…”