Islam S M Rashed Ul, Shahera Umme, Jahan Munira, Tabassum Shahina
Virology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD.
Cureus. 2023 Jun 30;15(6):e41202. doi: 10.7759/cureus.41202. eCollection 2023 Jun.
Background Hepatitis B virus DNA (HBV-DNA) assessment is recommended for diagnosing and monitoring chronic hepatitis B (CHB) patients. Quantitative hepatitis B surface antigen (qHBsAg) estimation adjunct to HBV-DNA is vital for assessing HBV chronicity and therapeutic prognosis. This study aimed to estimate the qHBsAg and compare its diagnostic performance with that of the HBV-DNA levels in CHB patients from Bangladesh. Methodology A total of 148 CHB patients were enrolled in this study. qHBsAg and hepatitis B e-antigen (HBeAg) were estimated using chemiluminescent and enzyme immunoassays, respectively, and HBV-DNA was quantified using real-time polymerase chain reaction. The parameters and diagnostic performances were analyzed by receiver operating characteristic (ROC) curve analysis. Results The overall levels (mean ± SD) of qHBsAg, HBV-DNA, and alanine aminotransferase (ALT) among the total population (n = 148) were 3.45 ± 0.80 log IU/mL, 4.40 ± 2.44 log IU/mL, and 86.17 ± 39.06 IU/L, respectively. Significant differences were observed in the levels of both qHBsAg (p = 0.004) and HBV-DNA (p < 0.0001) in cases with HBeAg positivity. qHBsAg levels showed a weak positive correlation with the levels of HBV-DNA and ALT in HBeAg-positive CHB patients, but no such relationship was observed in HBeAg-negative CHB patients. ROC curve analysis showed that the area under the curve for the qHBsAg level to distinguish high HBV-DNA levels (>5 log IU/mL) was 0.653 (p = 0.002), which indicated an acceptable diagnostic performance. The best cut-off of qHBsAg for predicting high HBV-DNA levels was 3.469 log IU/mL. Conclusions Our results indicated that qHBsAg might be a useful marker for monitoring HBV-DNA in CHB patients throughout treatment and follow-up.
推荐对慢性乙型肝炎（CHB）患者进行乙肝病毒DNA（HBV-DNA）检测以用于诊断和监测。定量乙肝表面抗原（qHBsAg）评估作为HBV-DNA检测的辅助手段，对于评估HBV慢性感染状态及治疗预后至关重要。本研究旨在评估孟加拉国CHB患者的qHBsAg水平，并将其诊断性能与HBV-DNA水平进行比较。方法：本研究共纳入148例CHB患者。分别采用化学发光法和酶免疫法检测qHBsAg和乙肝e抗原（HBeAg），采用实时聚合酶链反应对HBV-DNA进行定量分析。通过受试者工作特征（ROC）曲线分析对各项参数及诊断性能进行分析。结果：在全部148例研究对象中，qHBsAg、HBV-DNA及丙氨酸氨基转移酶（ALT）的总体水平（均值±标准差）分别为3.45±0.80 log IU/mL、4.40±2.44 log IU/mL和86.17±39.06 IU/L。HBeAg阳性患者的qHBsAg水平（p = 0.004）和HBV-DNA水平（p < 0.0001）均存在显著差异。在HBeAg阳性的CHB患者中，qHBsAg水平与HBV-DNA水平及ALT水平呈弱正相关，但在HBeAg阴性的CHB患者中未观察到这种关系。ROC曲线分析显示，qHBsAg水平区分高HBV-DNA水平（>5 log IU/mL）的曲线下面积为0.653（p = 0.002），表明其具有可接受的诊断性能。预测高HBV-DNA水平的qHBsAg最佳截断值为3.469 log IU/mL。结论：我们的结果表明，qHBsAg可能是CHB患者整个治疗及随访过程中监测HBV-DNA的有用标志物。
