Yılmaz Turgay, Özdemir Erdoğan, Düzenci Deccane, Bahçecioğlu İbrahim Halil
Department of Internal Medicine, Fethi Sekin City Hospital, Elazig, Turkey.
Department of Intensive Care Unit, Fethi Sekin City Hospital, Elazig, Turkey.
Int J Hepatol. 2025 Jul 28;2025:9096871. doi: 10.1155/ijh/9096871. eCollection 2025.
This study is aimed at comparing different clinical forms of chronic hepatitis B (CHB) infection (HBeAg-negative chronic HBV infection and HBeAg-positive and HBeAg-negative CHB patients) and evaluate their demographic, laboratory, virological, and histopathological characteristics, as well as investigate the relationship between quantitative HBsAg (qHBsAg) levels and these parameters. This prospective study included a total of 307 patients, comprising 142 HBeAg-negative chronic HBV infection and 165 CHB patients (39 HBeAg-positive and 126 HBeAg-negative). Patient data, including age, sex, ALT, AST, GGT, ALP, total bilirubin, HBV DNA, and qHBsAg levels, were recorded. Additionally, liver biopsy was performed in 111 cases (31 HBeAg-positive and 80 HBeAg-negative), and histological activity index (HAI) and fibrosis staging (ISHAK score) were evaluated. No significant differences were observed between HBeAg-negative chronic HBV infection and CHB patients in age and sex distribution. In the CHB group, ALT and HBV DNA levels were significantly higher ( = 0.014 and = 0.025, respectively). Among CHB patients, HBeAg-positive patients had significantly lower qHBsAg levels than HBeAg-negative patients (1805 vs. 4028 IU/mL, < 0.001). Histopathological evaluations showed no significant association between qHBsAg levels and fibrosis severity (ISHAK score > 2) or necroinflammatory activity (HAI > 6). ROC analysis confirmed the limited diagnostic value of qHBsAg for advanced fibrosis (AUC 0.511, 95% CI 0.454-0.569). In HBeAg-positive patients, a weak negative correlation was found between qHBsAg and HBV DNA levels ( = -0.388, = 0.015). Our study demonstrated variability in laboratory findings across different forms of CHB. Notably, HBeAg-positive patients exhibited high HBV DNA levels alongside low qHBsAg levels. The limited efficacy of qHBsAg as a fibrosis marker suggests caution in its clinical use. These findings underscore the importance of considering multiple parameters in assessing liver damage.
本研究旨在比较慢性乙型肝炎（CHB）感染的不同临床形式（HBeAg阴性慢性HBV感染以及HBeAg阳性和HBeAg阴性的CHB患者），评估其人口统计学、实验室、病毒学和组织病理学特征，并研究定量HBsAg（qHBsAg）水平与这些参数之间的关系。这项前瞻性研究共纳入307例患者，包括142例HBeAg阴性慢性HBV感染患者和165例CHB患者（39例HBeAg阳性和126例HBeAg阴性）。记录了患者的数据，包括年龄、性别、ALT、AST、GGT、ALP、总胆红素、HBV DNA和qHBsAg水平。此外，对111例患者（31例HBeAg阳性和80例HBeAg阴性）进行了肝活检，并评估了组织学活动指数（HAI）和纤维化分期（ISHAK评分）。在年龄和性别分布方面，HBeAg阴性慢性HBV感染患者与CHB患者之间未观察到显著差异。在CHB组中，ALT和HBV DNA水平显著更高（分别为P = 0.014和P = 0.025）。在CHB患者中，HBeAg阳性患者的qHBsAg水平显著低于HBeAg阴性患者（1805 vs. 4028 IU/mL，P < 0.001）。组织病理学评估显示，qHBsAg水平与纤维化严重程度（ISHAK评分>2）或坏死性炎症活动（HAI>6）之间无显著关联。ROC分析证实qHBsAg对晚期纤维化的诊断价值有限（AUC 0.511，95%CI 0.454 - 0.569）。在HBeAg阳性患者中，qHBsAg与HBV DNA水平之间存在弱负相关（r = -0.388，P = 0.015）。我们的研究表明，不同形式的CHB在实验室检查结果方面存在差异。值得注意的是，HBeAg阳性患者表现出高HBV DNA水平和低qHBsAg水平。qHBsAg作为纤维化标志物的疗效有限，提示在临床应用中应谨慎。这些发现强调了在评估肝损伤时考虑多个参数的重要性。
