Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jan;18(1):259-261.
doi: 10.1016/j.cgh.2018.12.039. Epub 2019 Jan 7.

HBV Genotype-Specific Levels of Hepatitis B Surface Antigen Improve HBV Phenotype Definition

Willem P Brouwer  1 , Qian Zhao  2 , Bettina E Hansen  3 , Daryl Lau  4 , Mandana Khalili  5 , Norah A Terrault  5 , Adrian M Di Bisceglie  6 , Robert P Perrillo  7 , Michael W Fried  8 , David Wong  9 , Jordan J Feld  9 , Steven H Belle  2 , Harry L A Janssen  10 ; Hepatitis B Research Network
Collaborators, Affiliations

HBV Genotype-Specific Levels of Hepatitis B Surface Antigen Improve HBV Phenotype Definition

Willem P Brouwer et al. Clin Gastroenterol Hepatol. 2020 Jan.

Abstract

Controversies exist regarding the classification of the different clinical phases of chronic hepatitis B (CHB) because hepatitis B virus (HBV) DNA and alanine aminotransferase levels fluctuate over time.1,2 To improve the distinction of clinical phases and the associated spectrum of clinical outcome,3,4 hepatitis B surface antigen (HBsAg) levels may be of help.5-7 We hypothesize that HBV genotype specific HBsAg levels are needed for the identification of different clinical HBV disease phases.7.

PubMed Disclaimer

Figures

Figure.
Figure.
Study workflow (panel A), Log10 HBsAg according to HBV phenotype (panel B), HBV genotype (panel C), and HBsAg by HBV DNA levels and HBV genotypes (A-D), with phenotype indicated (panel D). In panel D, HBsAg levels are plotted against HBV DNA, and the different HBV genotypes are plotted together with the defined phenotypes (in color). The fitted lines were created with predicted values obtained from a linear model, including genotype A-D, log10 HBV DNA level, and quadratic log10 HBV DNA level. HBV genotype A/B/C/D frequencies by HBV phenotype (N): Immune tolerant (IT):0/17/26/0, HBeAg-positive CHB: 41/88/129/9, HBeAg-negative CHB:32/110/62/14, Inactive carrier (IC): 52/86/62/23 respectively. *Some participants met multiple exclusion criteria (N=425 unique participants, N=454 criteria met); **N=758 unique participants, N=823 exclusion criteria met. αp-value for pairwise comparisons between IT and HBeAg+ active: 0.51; p-value for pairwise comparisons between HBeAg+ active and HBeAg- active: <0.001; βp-value between HBeAg- active and Inactive carrier <0.001. βp-value for pairwise comparisons between genotype A and B: <0.001; genotype A and D: 0.003; genotype B and C: <0.001; other pairwise comparisons were not significant (p>0.05).
Figure.
Figure.
Study workflow (panel A), Log10 HBsAg according to HBV phenotype (panel B), HBV genotype (panel C), and HBsAg by HBV DNA levels and HBV genotypes (A-D), with phenotype indicated (panel D). In panel D, HBsAg levels are plotted against HBV DNA, and the different HBV genotypes are plotted together with the defined phenotypes (in color). The fitted lines were created with predicted values obtained from a linear model, including genotype A-D, log10 HBV DNA level, and quadratic log10 HBV DNA level. HBV genotype A/B/C/D frequencies by HBV phenotype (N): Immune tolerant (IT):0/17/26/0, HBeAg-positive CHB: 41/88/129/9, HBeAg-negative CHB:32/110/62/14, Inactive carrier (IC): 52/86/62/23 respectively. *Some participants met multiple exclusion criteria (N=425 unique participants, N=454 criteria met); **N=758 unique participants, N=823 exclusion criteria met. αp-value for pairwise comparisons between IT and HBeAg+ active: 0.51; p-value for pairwise comparisons between HBeAg+ active and HBeAg- active: <0.001; βp-value between HBeAg- active and Inactive carrier <0.001. βp-value for pairwise comparisons between genotype A and B: <0.001; genotype A and D: 0.003; genotype B and C: <0.001; other pairwise comparisons were not significant (p>0.05).
Figure.
Figure.
Study workflow (panel A), Log10 HBsAg according to HBV phenotype (panel B), HBV genotype (panel C), and HBsAg by HBV DNA levels and HBV genotypes (A-D), with phenotype indicated (panel D). In panel D, HBsAg levels are plotted against HBV DNA, and the different HBV genotypes are plotted together with the defined phenotypes (in color). The fitted lines were created with predicted values obtained from a linear model, including genotype A-D, log10 HBV DNA level, and quadratic log10 HBV DNA level. HBV genotype A/B/C/D frequencies by HBV phenotype (N): Immune tolerant (IT):0/17/26/0, HBeAg-positive CHB: 41/88/129/9, HBeAg-negative CHB:32/110/62/14, Inactive carrier (IC): 52/86/62/23 respectively. *Some participants met multiple exclusion criteria (N=425 unique participants, N=454 criteria met); **N=758 unique participants, N=823 exclusion criteria met. αp-value for pairwise comparisons between IT and HBeAg+ active: 0.51; p-value for pairwise comparisons between HBeAg+ active and HBeAg- active: <0.001; βp-value between HBeAg- active and Inactive carrier <0.001. βp-value for pairwise comparisons between genotype A and B: <0.001; genotype A and D: 0.003; genotype B and C: <0.001; other pairwise comparisons were not significant (p>0.05).
Figure.
Figure.
Study workflow (panel A), Log10 HBsAg according to HBV phenotype (panel B), HBV genotype (panel C), and HBsAg by HBV DNA levels and HBV genotypes (A-D), with phenotype indicated (panel D). In panel D, HBsAg levels are plotted against HBV DNA, and the different HBV genotypes are plotted together with the defined phenotypes (in color). The fitted lines were created with predicted values obtained from a linear model, including genotype A-D, log10 HBV DNA level, and quadratic log10 HBV DNA level. HBV genotype A/B/C/D frequencies by HBV phenotype (N): Immune tolerant (IT):0/17/26/0, HBeAg-positive CHB: 41/88/129/9, HBeAg-negative CHB:32/110/62/14, Inactive carrier (IC): 52/86/62/23 respectively. *Some participants met multiple exclusion criteria (N=425 unique participants, N=454 criteria met); **N=758 unique participants, N=823 exclusion criteria met. αp-value for pairwise comparisons between IT and HBeAg+ active: 0.51; p-value for pairwise comparisons between HBeAg+ active and HBeAg- active: <0.001; βp-value between HBeAg- active and Inactive carrier <0.001. βp-value for pairwise comparisons between genotype A and B: <0.001; genotype A and D: 0.003; genotype B and C: <0.001; other pairwise comparisons were not significant (p>0.05).
See this image and copyright information in PMC

References

    1. Terrault NA, Bzowej NH, Chang KM, et al. AASLD guidelines for treatment of chronic hepatitis B. Hepatology 2016;63:261–83. - PMC - PubMed
    1. Di Bisceglie AM, Lombardero M, Teckman J, et al. Determination of hepatitis B phenotype using biochemical and serological markers. J Viral Hepat 2017;24:320–329. - PMC - PubMed
    1. Tseng TC, Liu CJ, Yang HC, et al. High levels of hepatitis B surface antigen increase risk of hepatocellular carcinoma in patients with low HBV load. Gastroenterology 2012;142:1140–1149 e3; quiz e13–4. - PubMed
    1. Tseng TC, Liu CJ, Yang HC, et al. Serum hepatitis B surface antigen levels help predict disease progression in patients with low hepatitis B virus loads. Hepatology 2013;57:441–50. - PubMed
    1. Nguyen T, Thompson AJV, Bowden S, et al. Hepatitis B surface antigen levels during the natural history of chronic hepatitis B: A perspective on Asia. Journal of Hepatology;52:508–513. - PubMed

Publication types