Thi Cam Huong Nguyen, Vu Hoang Anh, Luong Bac An, Makram Abdelrahman M, Elsheikh Randa, Huy Nguyen Tien, Le Hoa Pham Thi
Department of Infectious Diseases, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
Outpatient Department, University Medical Center, Ho Chi Minh City, Vietnam.
Gastro Hep Adv. 2023 Jan 31;2(4):467-474. doi: 10.1016/j.gastha.2023.01.017. eCollection 2023.
The prevalence of coexistence of HBsAg and anti-HBs in chronic hepatitis B virus (HBV)-infected patients is different between studies. The mutations on the S gene were proved as the cause of this coexistence. This study determined the frequency and factors associated with coexistence of HBsAg and anti-HBs in chronic HBV-infected patients.
This cross-sectional study was conducted at University Medical Center at Ho Chi Minh City, Vietnam, from April 2014 to December 2020. HBeAg, HBsAg, and anti-HBs were measured by chemiluminescent immunoassay. Mutations on the HBV small S gene from amino acids 1-227 were detected using Sanger sequencing on 177 patients.
A total of 521 chronic HBV-infected patients were enrolled, including 350 males (62.7%), 17.1% with hepatic fibrosis of ≥ F3 and 9.8% with hepatocellular carcinoma (HCC). The coexistence of HBsAg and anti-HBs was detected in 9.8%, with 17.9% among genotype C compared to 7.4% in genotype B, = .001. The coexistence group had lower levels of HBsAg titers ( = .052). There were significantly higher rates of coexistence in the group with HCC (19.6% vs 8.7%, = .013). The existence of point mutations on the major hydrophilic region and the "a" determinant region of HBV was more frequently detected in the HBsAg and anti-HBs coexistence group ( = .043 and = .008, respectively).
The coexistence of HBsAg and anti-HBs was detected more frequently in the HBV genotype C group. The coexistence status was related to lower HBsAg titers, mutations on the major hydrophilic region, and/or the "a" determinant and exposed significant relation with HCC.
慢性乙型肝炎病毒（HBV）感染患者中HBsAg与抗-HBs共存的发生率在不同研究中有所差异。已证实S基因上的突变是导致这种共存的原因。本研究确定了慢性HBV感染患者中HBsAg与抗-HBs共存的频率及相关因素。
本横断面研究于2014年4月至2020年12月在越南胡志明市大学医学中心进行。采用化学发光免疫分析法检测HBeAg、HBsAg和抗-HBs。对177例患者使用桑格测序法检测HBV小S基因第1至227位氨基酸的突变。
共纳入521例慢性HBV感染患者，其中男性350例（62.7%），17.1%有≥F3级肝纤维化，9.8%有肝细胞癌（HCC）。HBsAg与抗-HBs共存的检出率为9.8%，C基因型患者中为17.9%，B基因型患者中为7.4%，P = 0.001。共存组的HBsAg滴度较低（P = 0.052）。HCC组的共存率显著更高（分别为19.6%和8.7%，P = 0.013）。在HBsAg与抗-HBs共存组中，更频繁地检测到HBV主要亲水区和“a”决定簇区域的点突变（分别为P = 0.043和P = 0.008）。
HBV基因型C组中HBsAg与抗-HBs共存的检出频率更高。共存状态与较低的HBsAg滴度、主要亲水区和/或“a”决定簇的突变有关，且与HCC存在显著关联。
