Evaluation Of Serum HBsAg Levels Predicting Liver Fibrosis In Chronic Hepatitis B Virus Infections

Objective: To evaluate the value of serum hepatitis B surface antigen(HBs Ag)alone and combination with APRI score and FIB-4 index to predict liver fibrosis in chronic hepatitis B virus(HBV)infections.Methods: A total of 313 chronic hepatitis B virus infections were enrolled and divided into 189 and 124 patients according to the positive and negative HBe Ag antigens.All infected patients underwent percutaneous transhepatic biopsy to obtain liver tissue.Blood samples,liver function,hepatitis B markers and HBV DNA in the same period of hospitalization were collected and corresponding APRI score and FIB-4 index were calculated.The pathological inflammation of the liver was divided into the presence or absence of significant inflammatory activity(G = 0,1 vs G = 2,3,4),fibrosis divided into significant fibrosis(S = 0,1 vs S = 2,3,4).To evaluate the value of serum HBs Ag and HBV DNA load combined with APRI and FIB-4 in prediction of liver inflammation and fibrosis in CHB-infected patients.Serum levels of HBs Ag and HBV DNA were quantified for correlation with liver inflammation grade(G = 0,1,2,3,4)and fibrosis stage(S = 0,1,2,3,4).Statistical analysis SPSS24.0 software was used to calculate the area under the curve(AUC)of the receiver operating characteristic curve(ROC)and to determine the best cut-off value based on the Youden index.Results: 1.For HBe Ag-positive chronic HBV infections,serum HBs Ag level was significantly negatively correlated with inflammation grade and fibrosis stage.There was a significant negative correlation between serum HBV DNA load and fibrosis stage.2.For HBeAg-positive chronic HBV infections,whether ALT is normal or abnormal,serum HBs Ag levels alone can predict liver fibrosis grade 2 or above,the area under the ROC curve is 0.79.The cut-off point based on the Youden index is ?17465.97.IU/m L,the sensitivity was 81.1%,and the specificity was 74.3%;3.For HBeAg-positive chronic HBV infections,serum HBs Ag combined with APRI,FIB-4,and the combination of the three predicted liver fibrosis grade 2 or more compared alone predicted that the area under the ROC curve increased to 0.853,0.850and 0.865,which can improve forecast accuracy;4.For HBeAg-negative chronic HBV infections,serum HBV DNA load can predict liver inflammation stage 2 or more,with an area under the ROC curve is 0.701.Conclusion: For HBe Ag-positive chronic HBV infections,serum HBs Ag level alone can predict the presence of grade 2 or about fibrosis in liver tissue.The combination of APRI score and FIB-4 index can significantly improve the accuracy.When the serum HBs Ag of HBe Ag-positive infections?17465.97 IU / m L,the degree of fibrosis of grade 2 or above may already exist in their liver tissue.For HBe Ag-negative infections,serum HBV DNA load has certain predictive value for the stage 2 or above inflammation.