Rearch On The Correlation Between HbsAg,HBcAb And HBV DNA And Hepatic Inflammation And Fibrosis In Patients With Chronic Hepatitis B

Objective To analyze the correlation between serum hepatitis B surface antigen(HBsAg),hepatitis B core antibody(Hbc Ab),hepatitis B DNA(HBV DNA)quantification and the degree of hepatic inflammation and fibrosis in patients with chronic hepatitis B(CHB),and to provide basis for clinical diagnosis and treatment.Methods: Retrospective analysis of clinical data of 111 patients without antiviral treatment of CHB in The Second Affiliated Hospital of Dalian Medical University from January 2016 to December 2019.All selected patients have received ultrasound-guided liver biops y to determine the degree of liver inflammation and fibrosis.Serum etiology test results were divided into Hepatitis B E antigen(HBe Ag)positive group and HBe Ag negative gr oup;all patients had received serological examination,and the quantitative test results o f HBsAg,HBc Ab,and HBV DNA were recorded.Use statistical methods to analyze the correlation between HBsAg,HBc Ab,HBV DNA and liver inflammation and fibrosis;a ccording to the degree of inflammation in patients' liver pathology,divide them into G0-1 and G2-3 groups for comparison;according to different fibrosis staging was divided i nto S0-1 and S2-4 groups for comparison.The accuracy of serum HBsAg,HBc Ab,and HBV DNA to predict different inflammatory activities and fibrosis levels in liver tissue s of patients with CHB was evaluated.characteristic curve(ROC)method to calculate t he area under the ROC curve(AUC),the determination of the best cut-off value is based on the maximum Youden index.Results: 1.HBsAg quantification: The average HBsAg quantification in the HBe Ag negative group was 2.95 ± 1.02 log10 IU / ml,and the average HBsAg quantification in the HBe Ag positive group was 4.12 ± 0.57 log10 IU / ml.The HBe Ag negative group was significantly lower than the HBe Ag positive group.(t=7.612,p=0.000);2.HBV DNA quantification: The average value of HBV DNA quantification in the HBe Ag negative group was 3.72±1.27 log10IU/ml,and the average value of HBV DNA quantification in the HBe Ag positive group was 6.84±1.34log10IU/ml.HBe Ag negative group was significantly lower than HBe Ag positive group(t=12.552,p=0.000);3.Relationship between HBsAg and liver tissue inflammation grade and fibrosis stage: HBsAg level in HBe Ag positive group was negatively correlated with liver tissue inflammation grade(P <0.05),the correlation coefficient was-0.361;HBsAg and HBV DNA quantification and liver tissue fibrosis there was a negative correlation between the stages(P <0.05),and the correlation coefficients were-0.667 and-0.309,respectively;4.Relationship between HBsAg and HBV DNA quantification and liver inflammation grade and fibrosis stage:In the HBe Ag-positive group,the mean HBsAg of patients with grade G0-1 in liver tissue inflammation was significantly higher than that of grade G2-3(P <0.05);the quantitative mean values of HBsAg and HBV DNA in liver tissue fibrosis at S0-1 stage were significantly higher than those at S2-4 stage(P <0.05);5.Significance of HBsAg quantification in iudging inflammation in liver tissues:In the HBe Ag-positive group,the quantitative prediction of serum HBsAg for liver tissue inflammation grade 2 and above had an AUC of 0.790(95% CI: 0.623-0.957,P = 0.005),and the best cut-off point was ?4.52 log10 IU / m L,and the sensitivity was 80.0 %,Specificity was 78.0%;6.Significance of HBsAg quantification in judging fibrosis of liver tissue : In the HBe Ag-positive group,the AUC for quantitative prediction of liver fibrosis in stage 2 and above was 0.869(95% CI: 0.769-0.969,P = 0.000),the optimal cut-off point was ?4.15 log10IU/m L,and the sensitivity was 90.9%,with a specificity of 75.9%;7.Significance of HBV DNA quantification in judging liver tissue fibrosis : In the HBe Ag-positive group,the AUC for quantifying serum HBV DNA to predict liver fibrosis stage 2 and above was 0.782(95% CI: 0.655-0.909,P=0.001),and the optimal cut-off point was ?7.50 log10IU/m L,at which time the sensitivity was 86.4%,and the specificity was 65.5%.Conclusion: 1.In patients with HBe Ag-positive CHB,serum HBsAg levels can predict liver inflammation and fibrosis,the lower the serum HBsAg levels,the heavier the liver inflammation and fibrosis.2.In patients with HBe Ag-positive CHB,the level of HBV DNA in serum can predict the degree of liver fibrosis,the lower the level of HBV DNA in serum,the more severe the degree of liver and fibrosis,and has no predictive value for the degree of liver inflammation.3.In patients with HBe Ag-positive CHB,serum HBsAg was?4.52 log10IU/m L,suggesting that there were grade 2 and above inflammatory changes in liver tissue.4.In patients with HBe Ag-positive CHB,serum HBsAg ? 4.15 log10IU/ m L,suggesting that liver tissue has stage 2 and above fibrosis changes.5.In patients with HBe Ag-positive CHB,serum HBV DNA is ?7.50 log10 IU / m L,suggesting that the liver has stage 2 or more fibrosis.