Возможность использования количественного определения HBsAg при хронической HBV-инфекции с дельта-агентом

Abstract

We have conducted a pilot study to identify the association between the HBsAg level and activity of the pathological process in the liver, as well as possibility of quantitative assessment of HBsAg for monitoring chronic liver diseases caused by hepatitis B virus (HBV) and hepatitis D virus (HDV). Objective. To assess the possibility of using HBsAg levels as a predictor of disease activity and prognosis in patients with chronic HBV infection with delta-agent. Patients and methods. We analyzed serum specimens from 30 patients with HDV and HBV co-infection. Among 15 patients with chronic hepatitis B with delta-agent, there were 5 HBV DNA positive and 10 HBV DNA negative. Among patients with liver cirrhosis, HBV DNA was detected in 11 individuals, while 4 individuals had undetectable HBV DNA levels. Results. We found that mean HBsAg level in patients with chronic HBV infection and negative HBV DNA was 1.9 ± 0.56 IU/mL. Mean HBsAg level in patients with chronic HBV infection with delta-agent and positive HBV DNA was 4.3 ± 0.62 IU/mL (p < 0.05). High HBsAg levels correlated with elevated ALT in patients with chronic hepatitis B and delta-agent. Patients with liver cirrhosis caused by HDV had normal ALT levels, but elevated bilirubin concentrations regardless of HBV DNA presence and HBsAg level. Conclusion. High levels of HBsAg can be considered as a predictor of active disease in patients with chronic HBV infection with delta-agent and also a marker of transformation of chronic hepatitis B with delta-agent into liver cirrhosis. Key words: chronic hepatitis B with delta agent, liver cirrhosis, enzyme-linked immunosorbent assay, HBsAg levels, polymerase chain reaction