The Association among Serum Quantitative Hepatitis B Surface Antigen (qHBsAg), Intrahepatic HBV Markers and Liver Fibrosis in Chronic Hepatitis B (CHB) Patients

Abstract

Background: Recently, quantitative HBsAg has been used as a predictor for successful antiviral therapy in chronic hepatitis B (CHB) patients. Intrahepatic HBV-DNA levels have also been tested to know their relevance with clinical manifestation. However, their associations with liver fibrosis are still debatable. Objective: This study was aimed to evaluate the association between serum qHBsAg, serum HBV-DNA, intrahepatic HBV markers and hepatic fibrosis in CHB patients. Method: A cross-sectional study was done on naive CHB patients from September 2009 to June 2011. Quantitative serum HBsAg measurement was performed using the automated chemiluminescent microparticle immunoassay (Architect HBsAg QT assay, Abbott Laboratories, IL, USA). Serum qHBsAg was measured using the automated chemiluminescent microparticle immunoassay (Architect HBsAg QT assay, Abbott Laboratories, IL, USA). Intrahepatic cccDNA was measured quantitatively from biopsy specimen (QiAmp DNA Mini Kit, Qiagen, Germany). Values were log-transformed before being analyzed. Biopsy specimens should include at least 5 portal systems and 1.5 cm length to be eligible for evaluation using the METAVIR score. Results: 103 patients enrolled; 53 (51.9%) of them were men. Mean age was 42+11.6 (range 19-70) years old. There were 60 (58.3%) patients with HbeAg negative. Mean of log serum quantitative HBsAg was 2.54 for F0-F1 patients vs. 3.48 for F2-F4 patients (p < 0.001, student t test). The mean log serum HBV-DNA was 4.65 for F0-F1 vs. 6.69 for F2-F4 patients (p < 0.001; student t test). Intrahepatic rcDNA levels was higher in F2-F4 (median 14.37; range 0-3258.4 copies/GEq) than F0-F1 patients (median 0.50; range 0-514.4 copies/GEq); p < 0.001 (Mann-Whitney U test). In contrast, virion productivity was not differed statistically between the two groups (p 0.096). Conclusion: Quantitative serum HbsAg, HBV-DNA serum, and intrahepatic cccDNA are associated with fibrosis stage in chronic hepatitis B patients. HBV seromarkers might be used to predict disease severity.