Hong Wang1, Rong Yan2, Yin Zhou3, Ming Shan Wang4, Guo Qin Ruo5, Mei Juan Cheng6. 1. Department of Infectious Diseases, Zhejiang People's Provincial Hospital, No. 108, Shan Tang Road, Hangzhou, 310016, Zhejiang, China. hongwang71@yahoo.com. 2. Department of Infectious Diseases, Zhejiang People's Provincial Hospital, No. 108, Shan Tang Road, Hangzhou, 310016, Zhejiang, China. rosy@163.com. 3. Department of Infectious Diseases, Zhejiang People's Provincial Hospital, No. 108, Shan Tang Road, Hangzhou, 310016, Zhejiang, China. yinzhou@163.com. 4. Department of Infectious Diseases, Zhejiang People's Provincial Hospital, No. 108, Shan Tang Road, Hangzhou, 310016, Zhejiang, China. mingshangwang@163.com. 5. Department of Pathology, Zhejiang People's Provincial Hospital, No. 108, Shan Tang Road, Hangzhou, 310016, Zhejiang, China. rouguoqing@163.com. 6. Department of Infectious Diseases, Zhejiang People's Provincial Hospital, No. 108, Shan Tang Road, Hangzhou, 310016, Zhejiang, China. meijuanchen@163.com.
Abstract
BACKGROUND/AIM: The purpose of this study was to determine the relationship between hepatitis B e antigen (HBeAg) and hepatitis B surface antigen (HBsAg) levels and liver histology in HBeAg-positive patients with chronic hepatitis B virus (CHB) infection. METHODS: Serum HBsAg and HBeAg levels were analyzed, and liver biopsies were obtained from 203 HBeAg-positive CHB patients (62.6 % males; median age 31.3 years). The upper limit of normal (ULN) for ALT in this study was 30 and 19 U/L for males and females, respectively. Histologic assessment was based on Scheuer classification. RESULTS: ALT <2 × ULN, fibrosis stage <S2, and necro-inflammation grade <G2 were noted in 70 (34.5 %), 141 (69.5 %), and 105 (51.7 %) patients, respectively. Patients with significant histology (fibrosis stage ≥S2 and/or fibrosis stage of 1 plus inflammation grade ≥2) had significantly lower median HBsAg (13,998.4 and 42,186.5 IU/mL, respectively, p < 0.001) and HBeAg levels (540.5 and 1,206.8 S/CO, respectively, p < 0.001) than patients with insignificant histology. Among patients with ALT <2 × ULN, the area under the ROC curve for serum HBsAg and HBeAg levels was 0.76 and 0.70, respectively. Using a cutoff value of 17,558 IU/mL for HBsAg and 875.6 S/CO for HBeAg in patients with ALT <2×ULN, positive predictive values for insignificant histology were 87 and 86.8 %, respectively, whereas the negative predictive values were 50 and 47.1 %, respectively. CONCLUSIONS: Among HBeAg-positive patients with ALT <2 × ULN, high-serum HBsAg and HBeAg levels can equally accurately predict insignificant histology.
BACKGROUND/AIM: The purpose of this study was to determine the relationship between hepatitis B e antigen (HBeAg) and hepatitis B surface antigen (HBsAg) levels and liver histology in HBeAg-positive patients with chronic hepatitis B virus (CHB) infection. METHODS: Serum HBsAg and HBeAg levels were analyzed, and liver biopsies were obtained from 203 HBeAg-positive CHB patients (62.6 % males; median age 31.3 years). The upper limit of normal (ULN) for ALT in this study was 30 and 19 U/L for males and females, respectively. Histologic assessment was based on Scheuer classification. RESULTS: ALT <2 × ULN, fibrosis stage <S2, and necro-inflammation grade <G2 were noted in 70 (34.5 %), 141 (69.5 %), and 105 (51.7 %) patients, respectively. Patients with significant histology (fibrosis stage ≥S2 and/or fibrosis stage of 1 plus inflammation grade ≥2) had significantly lower median HBsAg (13,998.4 and 42,186.5 IU/mL, respectively, p < 0.001) and HBeAg levels (540.5 and 1,206.8 S/CO, respectively, p < 0.001) than patients with insignificant histology. Among patients with ALT <2 × ULN, the area under the ROC curve for serum HBsAg and HBeAg levels was 0.76 and 0.70, respectively. Using a cutoff value of 17,558 IU/mL for HBsAg and 875.6 S/CO for HBeAg in patients with ALT <2×ULN, positive predictive values for insignificant histology were 87 and 86.8 %, respectively, whereas the negative predictive values were 50 and 47.1 %, respectively. CONCLUSIONS: Among HBeAg-positive patients with ALT <2 × ULN, high-serum HBsAg and HBeAg levels can equally accurately predict insignificant histology.
Entities:
Keywords:
Aminotransferase; Biopsy; Hepatitis B e antigen; Hepatitis B surface antigen; Hepatitis B virus; Liver fibrosis
Authors: Margaret T Chen; Jean-Noel Billaud; Matti Sällberg; Luca G Guidotti; Francis V Chisari; Joyce Jones; Janice Hughes; David R Milich Journal: Proc Natl Acad Sci U S A Date: 2004-10-05 Impact factor: 11.205
Authors: Wai-Kay Seto; Ching-Lung Lai; Philip P C Ip; James Fung; Danny Ka-Ho Wong; John Chi-Hang Yuen; Ivan Fan-Ngai Hung; Man-Fung Yuen Journal: PLoS One Date: 2012-02-28 Impact factor: 3.240