Hepatitis B surface antigen in late hepatitis B infection

Area of Science:

• Hepatology
• Virology
• Oncology

Background:

• Hepatitis B surface antigen (HBsAg) is a key marker for chronic hepatitis B (CHB) infection.
• Its role in late-stage complications like cirrhosis and hepatocellular carcinoma (HCC) requires further clarification.
• Understanding HBsAg dynamics across the infection's natural history is crucial for patient management.

Purpose of the Study:

• To investigate the changes in HBsAg levels throughout the natural history of CHB infection.
• To evaluate the correlation between HBsAg and HBV DNA in different clinical phases, including cirrhosis and HCC.
• To assess the clinical significance of HBsAg in late-stage complications of hepatitis B.

Main Methods:

• Retrospective, cross-sectional study of 838 treatment-naive CHB patients.
• Classification into six groups: immunotolerance, immunoclearance, low replicative, HBeAg-negative, liver cirrhosis, and HCC.
• Measurement of serum HBsAg, HBeAg, HBV DNA, liver function tests, and correlation analysis.

Main Results:

• HBsAg levels significantly declined across infection phases (P < 0.001).
• Lower HBsAg levels were observed in decompensated versus compensated cirrhosis (P < 0.001).
• Significant positive correlations between HBsAg and HBV DNA were found in specific phases and cirrhosis, and advanced HCC.

Conclusions:

• HBsAg levels progressively decrease from chronic hepatitis B to cirrhosis and hepatocellular carcinoma.
• HBsAg and HBV DNA levels show significant correlations, particularly in specific phases and advanced liver disease.
• HBsAg quantification provides valuable insights into the natural history and progression of hepatitis B virus infection.