Role of quantitative hepatitis B surface antigen levels in predicting liver biopsy time in treatment-naive chronic hepatitis B patients

Abstract

Aim of the study: The quantitative hepatitis B surface antigen (qHBsAg) level indicates the amount of transcriptional activity of covalently closed circular DNA (cccDNA) and integrated DNA in hepatocytes which plays a role in development of chronic hepatitis B (CHB) and may help decide whether the treatment is necessary or not. The aim of this study is to evaluate the association between serum qHBsAg levels and viral replication and stage of liver fibrosis in treatment-naive CHB patients and to determine the role of qHBsAg levels in predicting when liver biopsy is necessary. Material and methods: 967 patients were included in the study. Because of refusal of liver biopsy the study was conducted on 123 patients. The association between qHBsAg levels with HBV DNA, a-fetoprotein, fibrosis stage and histology activity index was evaluated. Results: Of the patients, mean age was 48 ±11.2 years and 56.1% were male. We found that patients with HBV DNA ≥ 2000 IU/ml had a higher qHBsAg titer in comparison with HBV DNA < 2000 IU/ml. However, there was no relationship between qHBsAg titer and liver necroinflammation or fibrosis stage. Conclusions: Monitoring of qHBsAg together with HBV DNA may be helpful in CHB management. However, qHBsAg level does not provide knowledge about the timing of biopsy or the decision of CHB treatment.

Novel Biomarkers of Hepatitis B Virus and Their Use in Chronic Hepatitis B Patient Management

“…Baseline levels of HBsAg (<3 log 10 IU/mL) and HBV DNA (<3.3 log 10 IU/mL) were associated with a minimal risk of developing HCC after 10–15 years of follow up, with qHBsAg levels as an independent risk factor in HBeAg-negative, treatment-naïve patients, while HBV DNA and ALT levels were better predictors in HBeAg-positive patients [ 125 ]. Although the correlation between qHBsAg and fibrosis stage is still a matter of debate in treatment-naïve patients [ 126 , 127 ], qHBsAg has been found to be a marker of HBV-specific T cell and B cell response. While HBsAg levels were reported to have no impact on the specific immune cell composition, higher HBsAg levels were associated with an exhausted phenotype in CD4+ T cells and with dysfunctional B cells [ 128 ].…”

Correlation between quantitative HBsAg and quantitative HBV DNA in chronic hepatitis B patients: a systematic review and meta-analysis

“…a Data is presented in mean ± standard deviation or median (range)Tatar et al (2020) [25] 123 4625.9 ± 5614.9 IU/mL11,377.6 ± 25,598.4 IU/mL 0.303 0.001 Weak Turyadi et al (2013) [19] 152 3.25 (1.30-4.99) log IU/mL 4.24 (0.04-8.14) log IU/mL 0.659 < 0.001 Moderate…”