The Role of Quantitative HBsAg Levels in Chronic Hepatitis B Infection

INTRODUCTION: Hepatitis B and chronic Hepatitis B infection is important for patient management, including treatment and follow-up. Therefore, qHBsAg may help physicians to identify the stages of HBV infection. In our study, we aimed to investigate the differences in quantitative HBsAg (qHBsAg) levels at different stages of hepatitis B infection.
METHODS: This cross-sectional study included 183 patients who presented to the İnfectious diseases outpatient clinic of xxx Hospital between July and December 2020, were HBsAg-positive, and had not previously received treatment.
RESULTS: A total of 183 patients were included. Of them, 54.1% were male and the mean age was 40 years. The mean qHBsAg level was 2.155 IU/ml (interquartile range: 625-12.759). In correlation analysis, a statistically significant correlation was found between qHBsAg and age, ALT, AST and HBV DNA. In ROC (Recipient Operating Characteristic) analysis, which evaluates the predictive power of qHBsAg for chronic hepatitis, the area under the curve was shown to be statistically significant and the optimal cut-off value for qHBsAg was shown to be 3.081 IU/mL. The cut-off value for 95% specificity of qHBsAg in predicting chronic hepatitis was 38.641 IU/mL.
DISCUSSION AND CONCLUSION: Quantitative HBsAg is an easily applicable and relatively inexpensive test for distinguishing different stages of chronic hepatitis. Therefore, qHBsAg can help assess hepatitis B patients as being at low or high risk for progressive liver injury and plan treatment at the most appropriate time. In patients with HBV DNA> 2.000 IU/mL, initiation of treatment without liver biopsy can be considered if qHBsAg is> 38.000 IU/mL.