Serum Levels of Hepatitis B Surface Antigen and DNA Can Predict Inactive Carriers With Low Risk of Disease Progression.

Abstract

UNLABELLED:

Serum levels of hepatitis B virus (HBV) DNA (≤2000 IU/mL) and hepatitis B surface antigen (HBsAg) (<1000 IU/mL) have been shown to distinguish inactive carriers with high accuracy. The goal of this study was to validate the predictability of one-time measurement of quantitative HBsAg and HBV DNA levels for inactive carrier status and chronic hepatitis B (CHB) progression in a community-based cohort. This study included 1529 participants chronically infected with HBV genotype B or C from the REVEAL-HBV cohort. They were ascertained as inactive or active CHB after 18 months of follow-up. Validity of the one-time measurement was assessed by sensitivity, specificity, and receiver operating characteristic curves, while associations with clinical outcomes were calculated with Cox proportional hazards regressions. The one-time baseline measurement of HBsAg <1000 IU/mL and HBV DNA <2000 IU/mL distinguished inactive carriers from active CHB with a sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of 71%, 85%, 83%, 74%, and 78%, respectively. Those identified as inactive carriers using the one-time baseline measurement had multivariate adjusted hazard ratios of 0.36 (95% confidence interval [CI], 0.20-0.63) and 0.36 (0.23-0.56) for hepatocellular carcinoma and liver cirrhosis, respectively, and an adjusted rate ratio of 6.97 (95% CI, 5.21-9.33) for HBsAg seroclearance. Areas under the receiver operating characteristic curve of predicting these outcomes using the one-time definition were similar to those obtained when using long-term follow-up defined carrier status for prediction.

CONCLUSION:

This study confirms the predictability of a one-time combined HBsAg and HBV DNA measurement for future inactive carriers. This single-point strategy provides new and complementary information useful for management of patients with chronic hepatitis B infection. (Hepatology 2016;64:381-389).

• Authors: Jessica Liu, Hwai-I Yang, Mei-Hsuan Lee, Chin-Lan Jen, Richard Batrla-Utermann, Sheng-Nan Lu, Li-Yu Wang, San-Lin You, Chien-Jen Chen
• Journal: Hepatology (Baltimore, Md.) (Hepatology) Vol. 64 Issue 2 Pg. 381-9 (08 2016) ISSN: 1527-3350 [Electronic] United States
• PMID: 27079545 (Publication Type: Journal Article, Validation Study)
• Copyright: © 2016 by the American Association for the Study of Liver Diseases.

Chemical References

• DNA, Viral
• Hepatitis B Surface Antigens

Topics

• Adult
• Aged
• Carcinoma, Hepatocellular (blood, virology)
• Cohort Studies
• DNA, Viral (blood)
• Disease Progression
• Female
• Hepatitis B Surface Antigens (blood)
• Hepatitis B virus (genetics, isolation & purification)
• Hepatitis B, Chronic (blood, complications)
• Humans
• Liver Cirrhosis (blood, virology)
• Liver Neoplasms (blood, virology)
• Male
• Middle Aged