Low Serum Hepatitis B Surface Antigen Level Predicts Compensated Cirrhosis Caused by Chronic Hepatitis B in HBeAg Positive Patients in East China

Abstract

Backgrounds:Serum hepatitis B surface antigen (HBsAg) levels are associated with fibrosis in patients with chronic hepatitis B (CHB) infection.Objectives:The aim of our study was to evaluate serum HBsAg level as a biomarker for compensated cirrhosis in hepatitis B e antigen (HBeAg) positive CHB patients.Patients and Methods:Two-hundred and one HBeAg-positive Chinese CHB patients with or without cirrhosis were enrolled in this retrospective study. Cirrhosis was diagnosed based on liver biopsy. Furthermore, patients with decompensated cirrhosis were excluded. A statistical analysis was performed regarding the association between serum HBsAg level and compensated cirrhosis.Results:Patients with compensated cirrhosis had a significantly lower mean serum HBsAg level compared to those without cirrhosis (3.27 Log10 IU/mL VS 4.17 Log10 IU/mL, P < 0.001). Furthermore, examining the correlation with compensated cirrhosis revealed that lower level of serum HBsAg was a significant factor in multivariate analysis. The area under the receiver operating characteristics curve of serum HBsAg was 0.856 for compensated cirrhosis. A positive predictive value of 66.2% and negative predictive value of 90.7% were obtained with a cut-off value of < 3.60 Log10 IU/mL (4000 IU/mL) of serum HBsAg. Moreover, the rate of compensated cirrhosis increased to 75.0% after combining with APRI > 2.Conclusions:In HBeAg positive CHB patients, low serum HBsAg level is a useful predictor of compensated cirrhosis.

Clinical Usefulness of HBsAg Quantification in Patients with Chronic Hepatitis B Infection

“…In addition, when the relationship of genotype with qHBsAg was evaluated, in the immune clearance phase the qHBsAg level was found to be slightly higher in genotype D patients than genotype A patients. Consistent with these studies, Chung et al found out that the level of HBsAg decreased from the immune tolerant phase to the low replication phase, and in the same study, with old age, hepatocellular cancer or liver cirrhosis, it was observed that the level of qHBsAg was lower (13,14). Differentiation of inactive carriers and HBeAg negative CHB patients: qHBsAg levels can also be utilized to make a distinction between inactive HBsAg carriers and "e" antigen negative chronic hepatitis B patients.…”

Proposed model for the prediction of intrahepatic covalently closed circular DNA level in patients with chronic hepatitis B

“…Hepatitis B surface antigen levels decrease with age, aging can accelerate liver fibrosis progression, and advanced fibrosis can cause insulin resistance. [34][35][36][37][38][39] In addition, HBsAg level significantly correlated with IH-cccDNA level with considerably higher r value (r = 0.59) in the T cohort. These observations could be attributed to the statistical significance of FBS.…”

“…In the T cohort, FBS was closely associated with age ( P = 0.0023, r = 0.40). Hepatitis B surface antigen levels decrease with age, aging can accelerate liver fibrosis progression, and advanced fibrosis can cause insulin resistance . In addition, HBsAg level significantly correlated with IH‐cccDNA level with considerably higher r value ( r = 0.59) in the T cohort.…”

Performance evaluation of HBsAg by Lumipulse HBsAg-HQ: The agreement with HBsAg by Architect HBsAg-QT and the effectiveness in predicting liver tissue pathological states of chronic hepatitis B patients

“…17 This result was not consistent with the findings of a previous study conducted by Seto et al 18 For the cause-specific indexes, several studies have shown that serum HBsAg and HBV DNA in HBeAg-positive patients and HBV DNA but HBsAg in HBeAg-negative patients are valuable in predicting liver tissue pathological states. 7,[24][25][26][27][28][29] However, the predicable optimal pathological state of serum HBsAg and HBVDNA in the HBeAgpositive patients was not consistent between the different studies, 7,[24][25][26][27] although for the HBV DNA in the HBeAgnegative patients, there was an agreement in the pathological grade ≥G2 and stage ≥S2. 28,29 The results of this study were consistent with the findings by Cheng et al and Jia 7,[24][25][26][27] Furthermore, we did not observe significant differences in the AUCs for predicting the same liver tissue pathological states between the serum HBsAg-HQ and HBsAg-QT in the HBeAg-positive patients.…”