Correlation between quantitative HBsAg and quantitative HBV DNA in chronic hepatitis B patients: a systematic review and meta-analysis

Abstract

BackgroundHBV DNA assays have several limitations including being expensive and not widely available. Detection of HBsAg in serum has been the hallmark of HBV infection. However, previous studies regarding the association between HBsAg and HBV DNA revealed contradictory results. This study aims to reassess the correlation between HBsAg and HBV DNA in chronic hepatitis B patients.MethodsObservational studies with näive chronic hepatitis B patients were included, while studies with other coinfections were excluded. The studies were identified by searching through Google Scholar, PubMed, ScienceDirect, and Springer Link for English and Bahasa articles from 2011 to 2021. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) was followed. Study quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal.ResultsA total of 17 studies with 4134 participants met the criteria. The overall analysis revealed a moderate correlation between quantitative HBsAg and quantitative HBV DNA in the total sample of chronic hepatitis B patients (r = 0.57, 95% CI 0.40–0.75, P < 0.00001). In HBeAg + group, a moderate correlation was indicated while in HBeAg − revealed a weak association (r = 0.55, 95% CI 0.39–0.70, P < 0.00001 vs r = 0.29, 95% CI 0.20–0.38, P < 0.00001). The strongest correlation was discovered in HBeAg + chronic HBV infection phase (r = 0.59, 95% CI 0.35–0.82, P < 0.00001).ConclusionSerum HBsAg titer supports as a predictor of serum HBV DNA levels in clinical practice with moderate strength of correlation.Trial registrationThis review had been registered in PROSPERO (ID: CRD42023421246).