HBsAg Quantitative Values In Different Stages Of Chronic Hepatitis B Virus Infection And Their Correlation

BACKGROUND AND AIMS Chronic hepatitis B virus is prevalent in the world, epidemic intensity of HBV infection is difference between different regions. According to the WHO report, about Two billion people of worldwide had been infected with HBV, of which3.5million people was chronic HBV-carrier. Epidemiological investigation of hepatitis B showed that the general population of serum hepatitis B surface antigen carrying rate was7.18%among1to59years, accordingly, chronic HBV infection was about Ninety-three million people, of which about twenty million cases of patients was chronic hepatitis B of our country in2006. Therefore, HBV infection was an important public health problem in China and the world.With the development of biology, the understanding of HBV is increasingly developed. HBV DNA quantitative was firstly used as the initial diagnosis marker of HBV infection, and was used judging the status of HBV-infect people and long-term prognosis, playing a key role in the evaluating the efficacy of antiviral therapy treatment in recent years. The detection of HBsAg was found more than40years ago and used as the key marker of diagnosing HBV-infected, and now is still the most basic diagnosis marker of HBV. With the development and standard-analysis of quantitative of HBsAg, the clinical application of HBsAg is paid more and more attention, and was given a new significance. Clinical studies showed that the change of HBsAg quantitative values was closely related with the antiviral-treatment and withdrawing interferon; HBsAg can also be used to observe and analyze the nucleoside effect; HBsAg change can be used to predict the natural clearance of HBsAg. However, for the different natural stages of infection without treatment interventions of HBV (such as immune tolerance, immune clearance phase, inactive or low replication and reactivation period) distribution characteristics of HBsAg quantitative, Foreign scholars had made preliminary analysis, but domestic research reports is little. This paper aims to distribute the nature characteristics of quantitative HBsAg of chronic HBV infection between different clinical period and the correlation with HBV DNA and age, and provide the basis for the diagnosis of different stages and future intervention treatment of chronic HBV infection.METHODS Five hundred and sixty-four HBV-infected patients without antiviral therapy were recruited. Patients were divided into6groups according to the phase of HBV-infection:chronic HBV-carrier (65), inactive HBsAg carrier (164), HBeAg-positive chronic hepatitis B (71) and HBeAg-negative chronic hepatitis B (74), HBeAg-positive Hepatitis B liver cirrhosis (74) and HBeAg-negative Hepatitis B liver cirrhosis(42). Serum HBsAg were quantified using the Abbott ARCHITECT platform and HBV DNA by real-time fluorescence quantitative PCR method.RESULTS The HBsAg levels of chronic HBV-carrier, HBeAg-positive chronic hepatitis B, HBeAg-negative chronic hepatitis B, inactive HBsAg carrying, HBeAg-negative Hepatitis B liver cirrhosis and HBeAg-positive Hepatitis B liver cirrhosis were4.71(3.71-5.31),4.04(2.45-5.22),3.50(2.68-4.43),3.34(1.38-4.37),3.25(1.85-3.88) and3.15(2.51-3.92) log10IU/mL, respectively. Statistical difference of HBsAg were found between the6groups (χ2=263.0,p<0.001). HBsAg quantification positively correlated with HBV DNA in HBeAg positive group and HBeAg negative group (r=0.719, p<0.001and r=0.362,p<0.001). Negative correlation was found between HBsAg and age (r=-0.397.p<0.001). HBsAg quantification correlated negatively with age in HBeAg positive and negative patients (r=-0.353、r=-0.316, p<0.001). In patients older than40years, HBsAg quantification were statistically different between inactive HBsAg carrier group and HBeAg negative chronic hepatitis B group (3.14/3.53log10IU/mL, p<0.001), and the cut-off value was3.29log10IU/mLCONCLUSIONS HBsAg quantification is highest in chronic HBV-carrier, and lowest in Hepatitis B liver cirrhosis and inactive HBsAg carrying. HBsAg quantification is distributed differently in the various phases of HBV-infection. HBsAg correlated with both HBV DNA and age. HBsAg quantitative value is an important indicator to predict whether the inactive HBsAg carriers develop to the HBeAg negative chronic hepatitis B.