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Hepatitis B surface antigen levels during natural history of chronic hepatitis B: a Chinese perspective study
Lin-Yan Zeng1, Jiang-Shan Lian1, Jian-Yang Chen1
1Lin-Yan Zeng, Jiang-Shan Lian, Jian-Yang Chen, Hong-Yu Jia, Yi-Min Zhang, Dai-Rong Xiang, Liang Yu, Jian-Hua Hu, Ying-Feng Lu, Lin Zheng, Lan-Juan Li, Yi-Da Yang, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
Insights
Baseline hepatitis B surface antigen (HBsAg) levels vary significantly across chronic hepatitis B (CHB) phases in China. HBsAg quantification aids in understanding HBV natural history and predicting treatment response.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Chronic hepatitis B (CHB) is a global health concern.
- Understanding the natural history of CHB is crucial for effective management.
- Hepatitis B surface antigen (HBsAg) levels are a key marker in CHB infection.
Purpose of the Study:
- To determine baseline HBsAg levels in different phases of CHB in Chinese patients.
- To correlate HBsAg levels with HBV DNA and liver enzymes (ALT/AST) across CHB phases.
Main Methods:
- A cross-sectional study of 623 patients (CHB or uninfected) not on antiviral therapy.
- CHB patients classified into five phases: immune-tolerant (IT), immune-clearance (IC), HBeAg-negative hepatitis (ENH), low-replicative (LR), and liver cirrhosis (LC).
- HBsAg quantified using Abbott ARCHITECT assay; correlated with HBV DNA and ALT/AST.
Main Results:
- Median HBsAg titers differed significantly across CHB phases (P < 0.001).
- Highest HBsAg levels were observed in the IT phase (4.85 log10 IU/mL), lowest in the LC phase (2.69 log10 IU/mL).
- Strong correlation between HBsAg and HBV DNA in the IC phase (r = 0.683, P < 0.001); no correlation with ALT/AST.
Conclusions:
- Baseline HBsAg levels significantly vary across the five CHB phases, reflecting HBV natural history.
- HBsAg quantification may serve as a predictor for treatment efficacy with immune-modulators or nucleos(t)ide analogues.
Aim:
To determine the baseline hepatitis B surface antigen (HBsAg) levels during the different phases of chronic hepatitis B (CHB) patients in China.
Methods:
Six hundred and twenty-three hepatitis B virus or un-infected patients not receiving antiviral therapy were analyzed in a cross-sectional study. The CHB patients were classified into five phases: immune-tolerant (IT, n = 108), immune-clearance (IC, n = 161), hepatitis B e antigen negative hepatitis (ENH, n = 149), low-replicative (LR, n = 135), and liver cirrhosis (LC, n = 70). HBsAg was quantified (Abbott ARCHITECT assay) and correlated with hepatitis B virus (HBV) DNA, and serum alanine aminotransferase/aspartate aminotransferase (ALT/AST) in each phase of CHB was also determined.
Results:
Median HBsAg titers were different in each phase of CHB (P < 0.001): IT (4.85 log10 IU/mL), IC (4.36 log10 IU/mL), ENH (2.95 log10 IU/mL), LR (3.18 log10 IU/mL) and LC (2.69 log10 IU/mL). HBsAg titers were highest in the IT phase and lowest in the LC phase. Serum HBsAg titers showed a strong correlation with HBV viral load in the IC phase (r = 0.683, P < 0.001). No correlation between serum HBsAg level and ALT/AST was observed.
Conclusion:
The mean baseline HBsAg levels differ significantly during the five phases of CHB, providing evidence on the natural history of HBV infection. HBsAg quantification may predict the effects of immune-modulator or oral nucleos(t)ide analogue therapy.
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