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HBsAg quantification for identification of liver disease in chronic hepatitis B virus carriers



Background & Aims

Quantification of hepatitis B surface antigen (HBsAg) has been proposed as a useful diagnostic marker for clinical staging (identification of inactive carrier state) and prognosis of chronic hepatitis B virus (HBV) infection. The aim of this study was to investigate the correlation between HBsAg levels in serum and histological liver damage in patients with chronic infection.


HBsAg levels in serum (by Abbott Architect) were related to HBV DNA, ALT and histological score (n = 160) and covalently closed circular DNA (cccDNA) (n = 84).


HBsAg levels correlated with cccDNA, serum HBV DNA, ALT and high inflammation scores (P < 0.001). Among HBeAg-negative patients, an HBsAg level below 3.0 log10 IU/ml identified minimal liver damage (normal ALT and mild inflammation) with a predictive value of 92% (alone) or 96% (in combination with HBV DNA <4.0 log10 copies/ml), whereas an HBsAg level above 3.5 log10 IU/ml identified severe inflammation with a predictive value of 16% (alone) or 33% (in combination with HBV DNA >5.0 log10 copies/ml).


HBsAg levels reflect clinical stage and liver disease, and a combined quantification of HBsAg and HBV DNA may improve clinical staging.