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What does quantitative HBsAg level mean in chronic hepatitis D infection?
Berat Ebik1, M Sadik Cangul2, Kendal Yalçin3
1Division of Gastroenterology, University of Health Sciences, Diyabakir Gazi Yasargil Education and Research Hospital.
Insights
Quantitative HBsAg levels correlate with viral replication and liver damage in chronic hepatitis delta virus (HDV) infection. This marker is particularly useful for managing noncirrhotic HDV patients.
Area of Science:
- Hepatology
- Virology
- Clinical Medicine
Background:
- Hepatitis delta virus (HDV) infection is a significant cause of chronic liver disease.
- Understanding the relationship between viral markers and disease progression is crucial for effective management.
Purpose of the Study:
- To investigate the correlation between serum quantitative HBsAg levels and fibrosis and histological activity in patients with chronic HDV infection.
- To assess the utility of quantitative HBsAg as a marker for viral replication and liver disease severity.
Main Methods:
- A prospective study involving 98 patients with chronic HDV infection (2014-2020).
- Quantitative HBsAg levels were measured and compared with histological activity index (HAI), fibrosis score, HDV RNA, MELD score, and biochemical parameters.
Main Results:
- Quantitative HBsAg levels correlated significantly with HDV RNA levels in both cirrhotic and noncirrhotic patients.
- HBsAg levels showed a stronger correlation with liver enzymes (ALT, AST) in noncirrhotic patients.
- A significant correlation was observed between quantitative HBsAg and HAI in noncirrhotic HDV patients.
- Quantitative HBsAg and HDV RNA were not found to be predictive markers for cirrhosis.
Conclusions:
- Quantitative HBsAg level serves as an indicator of viral replication and histological activity in noncirrhotic chronic delta hepatitis.
- Quantitative HBsAg levels are valuable in managing chronic HDV infection, especially in patients without cirrhosis.
Objective:
In hepatitis delta virus (HDV) infection, which is an important etiological cause of chronic liver disease, the relationship between serum quantitative HBsAg level and fibrosis and histological activity was investigated.
Methods:
Between 2014 and 2020, 98 patients with chronic HDV infection (53 noncirrhotic, 45 cirrhotic) participated in this prospectively designed study. Quantitative HBsAg levels of the patients were measured and their relationship with the stage of chronic liver disease was compared with histological activity index (HAI), fibrosis score and HDV RNA, model for end-stage liver disease score and other biochemical parameters.
Results:
All patients were infected with genotype 1 (100%). HBeAg was positive in 8 (8.1%) of the patients. A correlation was found between quantitative HBsAg level and HDV RNA level in patients with both cirrhotic (r = 0.568; P < 0.001) and noncirrhotic (r = 0.644; P < 0.001) HDV infection. Alanine transaminase (P = 0.001; r = 0.495) and aspartate transaminase (P = 0.001; r = 0.511) levels correlated with quantitative HBsAg levels, more prominently in noncirrhotic patients. There was a correlation between quantitative HBsAg level and histological activity index (HAI) in patients with noncirrhotic HDV infection (P < 0.001; r = 0.664). In receiver operating characteristic analysis, both quantitative HBsAg (for cutoff: 1000; sensitivity 76%; specificity 17%; P = 0.335) and HDV RNA (for cutoff: 100000; sensitivity 2%; specificity 98%; P = 0.096) were not predictive markers for cirrhosis.
Conclusion:
Quantitative HBsAg level can be evaluated as an indicator of viral replication and histological activity in patients with chronic delta hepatitis without cirrhosis. We think that quantitative HBsAg level will be useful in the management of chronic HDV infection, especially in noncirrhotic patients.
