AIM: To analyze the quantitative differences between hepatitis B virus markers (HBV M) and HBV DNA in population with high-level or low-level HBsAg, and to reveal the characteristics of HBV DNA and HBV M in population with low-level HBsAg. METHODS: A total of 264 chronic HBV-infected patients were enrolled in our study, and were divided into low-level HBsAg group (147 cases) and high-level HBsAg group (117 cases) based on the HBsAg level or were divided into immune tolerance stage, immune clearance stage and non-active stage based on the natural history. Real-time PCR and microparticle enzyme immunoassay (MEIA) were used to determine the content of HBV DNA and HBV M in serum samples of high-level and low-level HBsAg patients, respectively, then the quantitative results were compared. RESULTS: There were statistically significant differences between HBV DNA and HBV M (anti-HBs, HBeAg and anti-HBe) of low-level HBsAg patients in immune tolerance stage (7 cases) and immune clearance stage(4 cases) (t=2.531-9.181, P<0.01-0.05). HBV DNA lower than 10(5) copies/L was found in 94.1% (128/136) of serum samples in non-active stage, and the detection rates of direct PCR and enriching PCR were 10.3% (14/136) and 10.3% (47/136) in low-level HBsAg group, respectively, and there were no correlations between HBV DNA and each of HBV M (P>0.05). In high-level HBsAg group, HBV DNA was positively correlated with HBeAg and anti-HBe in 25 cases of immune tolerance stage (r=0.744-0.772, t(r)=3.858-4.207, P<0.01), and was only negatively correlated with anti-HBs in 46 cases of immune clearance stage and 46 cases of non-active stage (r=-0.693 - -0.598, t(r)=-4.616 - -3.936, P<0.01-0.05). CONCLUSION: Population with low-level HBsAg have specific serological characteristics, which may be correlated with organic immune tolerance and individualized immune responses.
AIM: To analyze the quantitative differences between hepatitis B virus markers (HBV M) and HBV DNA in population with high-level or low-level HBsAg, and to reveal the characteristics of HBV DNA and HBV M in population with low-level HBsAg. METHODS: A total of 264 chronic HBV-infectedpatients were enrolled in our study, and were divided into low-level HBsAg group (147 cases) and high-level HBsAg group (117 cases) based on the HBsAg level or were divided into immune tolerance stage, immune clearance stage and non-active stage based on the natural history. Real-time PCR and microparticle enzyme immunoassay (MEIA) were used to determine the content of HBV DNA and HBV M in serum samples of high-level and low-level HBsAg patients, respectively, then the quantitative results were compared. RESULTS: There were statistically significant differences between HBV DNA and HBV M (anti-HBs, HBeAg and anti-HBe) of low-level HBsAg patients in immune tolerance stage (7 cases) and immune clearance stage(4 cases) (t=2.531-9.181, P<0.01-0.05). HBV DNA lower than 10(5) copies/L was found in 94.1% (128/136) of serum samples in non-active stage, and the detection rates of direct PCR and enriching PCR were 10.3% (14/136) and 10.3% (47/136) in low-level HBsAg group, respectively, and there were no correlations between HBV DNA and each of HBV M (P>0.05). In high-level HBsAg group, HBV DNA was positively correlated with HBeAg and anti-HBe in 25 cases of immune tolerance stage (r=0.744-0.772, t(r)=3.858-4.207, P<0.01), and was only negatively correlated with anti-HBs in 46 cases of immune clearance stage and 46 cases of non-active stage (r=-0.693 - -0.598, t(r)=-4.616 - -3.936, P<0.01-0.05). CONCLUSION: Population with low-level HBsAg have specific serological characteristics, which may be correlated with organic immune tolerance and individualized immune responses.