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Association of Hepatitis B Surface Antigen Levels With Long-Term Complications in Chronic Hepatitis B Virus

Anadi Mahajan1, Saifuddin Kharawala1, Supriya Desai1

  • 1Bridge Medical Consulting Ltd, London, UK.

Journal of Viral Hepatitis
|August 16, 2024
PubMed

Insights

Hepatitis B surface antigen (HBsAg) levels predict long-term outcomes like cirrhosis and liver cancer in untreated chronic hepatitis B patients. Declining HBsAg levels correlate with treatment success and viral clearance.

Area of Science:

  • Hepatology and Virology
  • Infectious Diseases

Background:

  • Chronic hepatitis B virus (HBV) infection is a major global health concern, potentially leading to severe liver conditions like cirrhosis and hepatocellular carcinoma (HCC).
  • Hepatitis B surface antigen (HBsAg) serves as a key indicator of HBV infection, and its quantification offers potential clinical utility.

Purpose of the Study:

  • To systematically review the association between HBsAg titres and long-term disease outcomes in chronic HBV infection.
  • To evaluate the relationship between HBsAg titres (or their changes) and clinical/treatment characteristics.

Main Methods:

  • A systematic literature review of studies published in MEDLINE and Embase from January 2000 to March 2023.
  • Inclusion of 82 studies, predominantly retrospective cohort studies (51%) with a majority conducted in Asia (85%).

Main Results:

  • HBsAg levels predicted long-term cirrhosis and HCC development in untreated patients; data were inconclusive for mixed or treated populations.
  • HBsAg titres correlated significantly with virological markers (HBV DNA, HBcrAg, HBeAg, HBV RNA, intrahepatic cccDNA, and HBsAg expression).
  • A decline in HBsAg titres was observed over time, more pronounced in HBeAg-positive phases, and associated with HBsAg seroclearance and reduced intrahepatic HBV DNA/cccDNA.

Conclusions:

  • HBsAg levels and their rate of decline are valuable for assessing, managing, and predicting outcomes in chronic HBV infection.
  • Further research is needed in diverse populations and among treated patients to solidify these findings.

Keywords:
chronic hepatitis Bcirrhosisclinical relevancehepatitis B surface antigenhepatocellular carcinoma

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