The assessment of liver fibrosis in patients with chronic hepatitis B (CHB) is of great importance in evaluating the phases of chronic hepatitis B viral infection, prompt administration of antiviral therapy, prevention of disease progression and late complications of CHB infection. Aim: to investigate the clinical significance of quantitative HBs antigen as a predictor for liver fibrosis in patients with HBe antigen negative chronic hepatitis B and inactive carriers. Material and Methods: the study included 44 treatment naïve patients with chronic hepatitis B, divided into two groups, HBeAg negative chronic HBV infection or inactive carriers (IC) and HBeAg negative chronic hepatitis B patients. All patients underwent laboratory, serologic testing, ultrasound and transient elastography (TE). In both patient groups, quantitative HBs antigen (HBsQ), alanine aminotransferase (ALT), hepatitis B virus deoxyribonucleic acid (HBV DNA) and liver fibrosis were analyzed. Results: The value of HBsQ is significantly higher in patients with HBeAg negative CHB 2477.02±4535.44 IU/ml than in the IC group 8791±11891 IU/ml; Z=3.32, p<0.001 (p=0.0009). In IC patients, 1 (4.76%) had fibrosis and 20 (95.24%)) did not have fibrosis. Out of 23 patients with HBeAg negative chronic hepatitis B, 8 (34.78%) had fibrosis and 15 (65.22%) did not have fibrosis. Patients with HBeAg negative hepatitis B had significantly higher liver fibrosis than IC; Fisher Exact Test p<0.05 (p=0.02). The increase of HBsQ for one single unit (IU/ml) does not have predictive value for fibrosis (Ext (B) =1.00), 95% C.I. for EXP (B): 1.00-1.00 / p>0.05. Conclusion: Quantitative hepatitis B surface antigen has intermediate weak statistically insignificant prediction for liver fibrosis R=0.25 (p<0.10).
3. Lavanchy D. “Hepatitis B virus epidemiology disease burden treatment and current and emerging prevention and control measures.” J. Viral Hepat. 2004; 11: 97–107.
4. Bedossa P Carrat F.“Liver biopsy: the best not the gold standard. J Hepatol. 2009; 50: 1-3.
5. Xu X Su Y Song R et all: “Performance of transient elastography assessing fibrosis of single hepatitis B infection: A systematic review and meta-analysis of a diagnostic test.” Hepatol Int. 2015; 9: 558-66
6. Gheorghița V. et al.“Quantitative serum HBsAg in chronic hepatitis B.” Therapeutics Pharmacology and Clinical Toxicology. 2012; 16 (3): 155-162.
7. LiawYF. “Clinical Utility of Hepatitis B surface Antigen Quantitation in Patients with Chronic Hepatitis B: A Review.” Hepatology. 2011; 53: 2121-2129.
8. Chevaliez S: “Is HBsAg quantification ready for prime time?” Clin Res Hepatolo Gastroenterol. 2013; 37: 559-63.
9. Loggi E Vitale G. Conti F. Bernardi M. “Chronic hepatitis B: Are we close to a cure?” Digestive and Liver Disease. 2015; 47: 836-841.
10. Martinot-PeginouxM et al.: HBsAg quantification to predict natural history and treatment outcome in chronic hepatitis B patients. Clin Liver Dis. 2013 17: 399-412.
11. Samant H Joshi Aet al. “Correlation of QuantitativeHBsAg with Quantitative HBV DNA in Different Phases of Chronic Hepatitis B (CHB) Patients.”J Liver Res Disord Ther. 2016; 1(3).
12. Thompson AJ Nguyen T Iser D et al. “Serum hepatitis B surface antigen and hepatitis B e antigen titers: disease phase influences correlation with viral load and intrahepatic hepatitis B virus markers.” Hepatology. 2010; 51: 1933–1944.
13. Brunetto MR. “A new role for an old marker HBsAg.” J Hepatol. 2010; 52: 475-477.
14. European Association for the Study of the Liver. EASL clinical practice guidelines: “Management of chronic hepatitis B virus infection.” J Hepatol. 2017; 67: 370–398.
15. Seto WK Wong DK et al. “High hepatitis B surface antigen levels predict insignigicant fibrosis in hepatitis B e antigen positive chronic hepatitis B.” PLoS One. 2012; 7: e43087
16. Zhu HY Zhang XS. “Relationship between HBV DNA load and levels of serum HBsAg in patients with chronic hepatitis B.” European Review for Medical and Pharmacological Sciences. 2016; 20: 2061-2064.
17. Balkan A. Namiduru M.et al. “Are Serum Quantitavie Hepatitis B surface Antigen Levels Liver Histopathology and Viral Loads related in Chronic Hepatitis B-Infected Patients?” Saudi J Gastronterol. 2016; 22(3) 208-214.
18. Hong MZ Huagn WQ et al. “Enhanced HBsAg synthesis correlates with increased severity of fibrosis in chronic hepatitis B patients.” PLoS One. 2014; 9: 1:e87344.
19. Günal et al. “Relation between serum quantitative HBsAg ALT and HBV DNAlevels in HBeAg negative chronic HBV infection.” Turk J Gastroenterol. 2014; 25: 142-6.
20. Liu J Yang H Lee M.2 Jen C1 Utermann R. Lu S.et all. “Serum Levels of Hepatitis B SurfaceAntigen and DNA Can Predict Inactive Carriers With Low Risk of Disease Progression.” Hepatology. 2016; 64: 381-389.