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. 2015 Aug 30;15(8):e29183.
doi: 10.5812/hepatmon.29183. eCollection 2015 Aug.

Low Serum Hepatitis B Surface Antigen Level Predicts Compensated Cirrhosis Caused by Chronic Hepatitis B in HBeAg Positive Patients in East China

Wen Jia  1 , Xun Qi  2 , Yan-Yan Ji  3 , Yun-Hao Xun  4 , Hong Wang  3 , Wen-Hong Zhang  1 , Jian-Hua Yang  3 , Jin-Yu Wang  2 , Hao-Xiang Zhu  2 , Ri-Cheng Mao  2 , Ji-Ming Zhang  1
Affiliations

Low Serum Hepatitis B Surface Antigen Level Predicts Compensated Cirrhosis Caused by Chronic Hepatitis B in HBeAg Positive Patients in East China

Wen Jia et al. Hepat Mon. .

Abstract

Backgrounds: Serum hepatitis B surface antigen (HBsAg) levels are associated with fibrosis in patients with chronic hepatitis B (CHB) infection.

Objectives: The aim of our study was to evaluate serum HBsAg level as a biomarker for compensated cirrhosis in hepatitis B e antigen (HBeAg) positive CHB patients.

Patients and methods: Two-hundred and one HBeAg-positive Chinese CHB patients with or without cirrhosis were enrolled in this retrospective study. Cirrhosis was diagnosed based on liver biopsy. Furthermore, patients with decompensated cirrhosis were excluded. A statistical analysis was performed regarding the association between serum HBsAg level and compensated cirrhosis.

Results: Patients with compensated cirrhosis had a significantly lower mean serum HBsAg level compared to those without cirrhosis (3.27 Log10 IU/mL VS 4.17 Log10 IU/mL, P < 0.001). Furthermore, examining the correlation with compensated cirrhosis revealed that lower level of serum HBsAg was a significant factor in multivariate analysis. The area under the receiver operating characteristics curve of serum HBsAg was 0.856 for compensated cirrhosis. A positive predictive value of 66.2% and negative predictive value of 90.7% were obtained with a cut-off value of < 3.60 Log10 IU/mL (4000 IU/mL) of serum HBsAg. Moreover, the rate of compensated cirrhosis increased to 75.0% after combining with APRI > 2.

Conclusions: In HBeAg positive CHB patients, low serum HBsAg level is a useful predictor of compensated cirrhosis.

Keywords: Chronic; Hepatitis B; Hepatitis B Surface Antigens; Hepatitis B e Antigens; Liver Cirrhosis.

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Figures

Figure 1.
Figure 1.. Flowchart of Study Participants
Abbreviations: CHB, chronic hepatitis B, HBsAg hepatitis B surface antigen.
Figure 2.
Figure 2.. The Differences in HBsAg Serum Levels for Different Stages of Fibrosis
Serum HBsAg were expressed as mean ± standard deviation, the results showed that serum HBsAg decreased with the process of fibrosis. There was a strong inverse correlation between serum HBsAg and fibrosis (r = -0.668, P < 0.001). Abbreviations: HBsAg, hepatitis B surface antigen.
Figure 3.
Figure 3.. The Differences in HBsAg Serum Levels Between CC Group and Non-Cirrhotic Group
CC group: patients with compensated cirrhosis; non-cirrhotic group: patients without cirrhosis.
Figure 4.
Figure 4.. Receiver Operating Characteristic Curves of Parameters in Predicting Compensated Cirrhosis
Abbreviations: HBsAg, hepatitis B surface antigen; and APRI, aspartate aminotransferase to platelet ratio index.
Figure 5.
Figure 5.. Rate of Compensated Cirrhosis Among Subgroups of Patients Stratified by HBsAg and APRI
Abbreviations: APRI, aspartate aminotransferase to platelet ratio index; and HBsAg, hepatitis B surface antigen.
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