The Correlation Between Serum HBsAg Quantitative Levels And Residual Amount Of HBVDNA And Its Clinical Significance

Objective:To Study the correlation between residual amount of HBVDNA and HBsAg levels during the low viral load of patients with chronic HB V infection in the process of different clinical courses and nucleoside(acid)analogues antiviral treatment,which can provide a new idea of predicting the sustained virological response and drug withdrawal time in the process of antiviral treatment.Methods:1、Collect serum,clinical data of patients in hangzhou xixi hospitation from August 2013 to September 2015,213 cases of patients without antiviral treatment of chronic hepatitis B,172 cases of patients in the process of nucleoside(acid)analogs antiviral treatment.2、Biochemical indicator is tested by Beckman coulter fully automatic biochemical analyzer;serum hepatitis B three-line is quantified by Abbott laboratories full automatic immune luminescence analyzer;HBV DNA level.is tested by the roche COBAS AmpliPrep/COBAS TaqManHBVTest,version 2.0 detection.3、All the statistics done by SPSS 19.0 statistical software package,with double side test,There were statistically significant differences in P<0.0 5.Results:1、without antiviral treatmentSerum HBVDNA and HBsAg exist linear correlation(r=0.467,p=0.000),during the HBeAg positive,log10 HBVDNA and log10HBsAg show significant correlation(r=0.79,p=0.000),while also in the HBeAg negative(r=0.264,p=0.001),but the correlation decreases obviously.In the comparison between the four groups of Chronic hepatitis B,cirrhosis of the liver(compensation period),cirrhosis of the liver(decompensation period),liver cancer,there is no statistical differences in HBVDN A(χ2=2.49,P=0.477)and AST(χ2=16.77,P=0.073).But there is statistical difference between age(χ2=3,P=0.00),HBsAg(χ2=12.4,P=0.006)and TBIL(χ2=36.07,P=0.01).Quantitative comparison in HBsAg were:chronic hepatitis B>liver cirrhosis(compensation period)>liver cancer>liver cirrhosis(decompensation period);When in low viral load(20th<HBVDNA<10000 IU/ml,log10HBVDNA log10HBsAg with no correlation(r=0.16,p=0.07),but there has correlation when HBVDNA>10000 IU/ml(r=0.31,p=0.016).2、with nucleoside(acid)analogs antiviral treatmentIn the process of NAs antiviral treatment,serum HBVDNA and HBsAg doesn’t exist correlation(r=0.075,p=0.553).There is statistically difference between HBsAg quantification of three groups(undetected,<20,>20 groups)(χ2=7.087,p=0.029).The quantification of HBsAg has statistically significant difference between the four different clinical course groups(χ2=16.603,p=0.01),and HBsAg quantitative comparison are:chronic hepatitis B>liver cirrhosis(compensation period)>liver cancer>liver cirrhosis(decompensation period).In different antiviral length,HBVDNA turns shade rate has no significant statistical differences between five groups(χ2=6.713,p=0.152),NAs antiviral treatment less than 3 years compared with more than 3 years,HBsAg began to have statistically significant difference(Z=-1.94,P=0.05).Conclusion:1、without antiviral treatment,Serum HBVDNA and HBsAg exist linear correlation,during the HBeAg positive,log10 HBVDNA and log10HBsAg show significant correlation,while also in the HBeAg negative correlation,but the correlation decreases obviously.When in low viral load(20th<HBVDNA<10000 IU/ml,log10HBVDNA log10HBsAg with no correlation,but there has correlation when HBVDNA>10000 IU/ml,prompting "separation" phenomenon may exist between HBsAg and HBVDNA at low viral loads.2、with NAs antiviral treatment,the serum HBVDNA is not associated with HBsAg,indicating HBVDNA drops falling out of sync with HBsAg.In different antiviral length,less than three years,compared with more than 3 years,HBsAg began to have statistically significant difference,indicating more than 3 years for the antiviral treatment has a great significance in the chronic HBV infected patients.3、The quantification of HBsAg has statistically significant difference between the four different clinical course groups,Whether with or without NAs antiviral treatment,and HBsAg quantitative comparison are:chronic hepatitis B>liver cirrhosis(compensation period)>liver cancer>liver cirrhosis(decompensation period).Suggesting HBsAg possibly declines associate with host immune status,the state of the liver.