TY - JOUR
T1 - Clinical significance of serum HBsAg levels and association with liver histology in HBeAg positive chronic hepatitis B
AU - Cheng, Pin Nan
AU - Tsai, Hung Wen
AU - Chiu, Yen Cheng
AU - Ho, Cheng Hsun
AU - Wu, I. Chin
AU - Chang, Ting Tsung
N1 - Funding Information:
T.-T. C. has received research funding from Gilead Sciences, Bristol-Myers Squibb Company, GlaxoSmithKline, Merck Sharp & Dohme (I.A.) Corporation and Pfizer Inc. All other authors have no conflicts.
PY - 2013/8
Y1 - 2013/8
N2 - Background: Despite its recognized role as a prognostic marker for antiviral treatment, the clinical significance of serum hepatitis B surface antigen (HBsAg) level in the immune-clearance stage of chronic hepatitis B remains unclear. Objectives: To characterize how HBsAg level and various clinical and virological factors are related and analyze the correlation of HBsAg with liver histology. Study design: A total of 198 treatment-naïve HBeAg-positive chronic hepatitis B patients were enrolled. Serum HBV DNA and HBsAg were determined quantitatively. Mutations of precore or basal core promoter (BCP) were also determined. Finally, liver necroinflammation grading and fibrosis stage were evaluated by Knodell score and Ishak score, respectively. Results: Lower HBsAg levels were found in patients with genotype C HBV infection, or in the presence of precore or mutations, or Knodell necroinflammation grading ≥7, or advanced fibrosis (Ishak stage 4-6). HBsAg level displayed a strong correlation with HBV DNA ( r= 0.727, P<. 0.001) and also exhibited a positive correlation with intrahepatic HBcAg expression in either cytoplasm ( r= 0.420, P<. 0.001) or nucleus ( r= 0.401, P<. 0.001). Examining the correlation with advanced liver fibrosis revealed that HBsAg level is a significant factor in univariate analysis and is the only independent factor in multivariate analysis (Coefficient: -0.975, P= 0.039, OR: 0.377, 95% CI: 0.149-0.953). Conclusions: HBsAg level varied with different clinical or virological categories. Lower baseline levels of HBsAg might reflect the status of advanced liver fibrosis in HBeAg positive chronic hepatitis B patients.
AB - Background: Despite its recognized role as a prognostic marker for antiviral treatment, the clinical significance of serum hepatitis B surface antigen (HBsAg) level in the immune-clearance stage of chronic hepatitis B remains unclear. Objectives: To characterize how HBsAg level and various clinical and virological factors are related and analyze the correlation of HBsAg with liver histology. Study design: A total of 198 treatment-naïve HBeAg-positive chronic hepatitis B patients were enrolled. Serum HBV DNA and HBsAg were determined quantitatively. Mutations of precore or basal core promoter (BCP) were also determined. Finally, liver necroinflammation grading and fibrosis stage were evaluated by Knodell score and Ishak score, respectively. Results: Lower HBsAg levels were found in patients with genotype C HBV infection, or in the presence of precore or mutations, or Knodell necroinflammation grading ≥7, or advanced fibrosis (Ishak stage 4-6). HBsAg level displayed a strong correlation with HBV DNA ( r= 0.727, P<. 0.001) and also exhibited a positive correlation with intrahepatic HBcAg expression in either cytoplasm ( r= 0.420, P<. 0.001) or nucleus ( r= 0.401, P<. 0.001). Examining the correlation with advanced liver fibrosis revealed that HBsAg level is a significant factor in univariate analysis and is the only independent factor in multivariate analysis (Coefficient: -0.975, P= 0.039, OR: 0.377, 95% CI: 0.149-0.953). Conclusions: HBsAg level varied with different clinical or virological categories. Lower baseline levels of HBsAg might reflect the status of advanced liver fibrosis in HBeAg positive chronic hepatitis B patients.
UR - http://www.scopus.com/inward/record.url?scp=84879269775&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84879269775&partnerID=8YFLogxK
U2 - 10.1016/j.jcv.2013.04.012
DO - 10.1016/j.jcv.2013.04.012
M3 - Article
C2 - 23731848
AN - SCOPUS:84879269775
SN - 1386-6532
VL - 57
SP - 323
EP - 330
JO - Journal of Clinical Virology
JF - Journal of Clinical Virology
IS - 4
ER -
