The change of the quantitative HBsAg level during the natural course of chronic hepatitis B

Liver Int. 2011 Jul;31(6):817-23. doi: 10.1111/j.1478-3231.2011.02516.x. Epub 2011 Mar 22.

Abstract

Background: There is insufficient information about HBsAg levels and their correlation with serum hepatitis B virus (HBV) DNA in chronic hepatitis B (CHB).

Aims: We aimed to describe HBsAg levels during various phases of CHB and to investigate the correlation with serum HBV DNA levels.

Methods: A total of 645 treatment-naïve Korean CHB patients were included in this retrospective cross-sectional study. They were categorized into immune tolerance (IT, n=56), HBeAg-positive hepatitis (EPH, n=150), inactive carrier (IC, n=274) and HBeAg-negative hepatitis (ENH, n=165). The baseline HBsAg and HBV DNA levels were measured.

Results: The mean HBsAg titres (log IU/ml) differed (P<0.001): IT 4.29, EPH 3.64, IC 2.05 and ENH 3.23. In 645 patients, HBsAg and HBV DNA showed a significant correlation (r=0.693, P<0.001), and this was also observed in the IT, EPH and IC groups (r=0.664, r=0.541, r=0.505, respectively, all P<0.001), but not in the ENH group (r=0.093, P=0.321). Age had a negative correlation with HBsAg (r=-0.451, P<0.001). The cirrhotic patients had a significantly lower HBsAg level than the non-cirrhotic patients (2.41 ± 1.36 vs. 3.02 ± 1.21 log IU/ml, P<0.001).

Conclusions: The HBsAg level varied significantly in different phases of CHB and was correlated with HBV DNA during the IT, EPH and IC phases. These findings can provide additional information to understand the natural course and pathogenesis of CHB.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Biomarkers / blood
  • Carrier State
  • Chi-Square Distribution
  • Cross-Sectional Studies
  • DNA, Viral / blood
  • Disease Progression
  • Female
  • Hepatitis B Surface Antigens / blood*
  • Hepatitis B virus / genetics
  • Hepatitis B virus / immunology*
  • Hepatitis B, Chronic / complications
  • Hepatitis B, Chronic / diagnosis*
  • Hepatitis B, Chronic / immunology
  • Humans
  • Immune Tolerance
  • Liver Cirrhosis / virology
  • Male
  • Middle Aged
  • Republic of Korea
  • Retrospective Studies
  • Time Factors
  • Viral Load
  • Young Adult

Substances

  • Biomarkers
  • DNA, Viral
  • Hepatitis B Surface Antigens