Physicians Meet on Gastroenterology and Digestive Disorders Conference
Frankfurt, Germany
Tarek A Elshazly
Mansoura University, Egypt
Title: Predictive Value of Quantitative Estimation of Hepatitis B Surface Antigen and DNA load in serum of Chronic Hepatitis B Patients
Biography
Biography: Tarek A Elshazly
Abstract
Quantitative estimation of serum levels of hepatitis B surface antigen (HBsAg) and HB viral DNA load (HB VDL) in chronic hepatitis B (CHB) patients and their applicability for differentiating between disease phases and to predict the outcome of liver biopsy. Patients & Methods: The study included 113 patients; 67 males and 46 females; with mean age of 42.6±10.8 years and mean disease duration of 5.6±1.1 years. All patients underwent clinical examination, and blind liver biopsy was taken for necrosis and fibrosis histopathological scoring. Fasting venous blood samples were collected for estimation of serum AST and ALT, estimation of hepatitis B serological markers by ELISA and quantitative estimation of serum HBsAg by Roche Cobas e 411 analyzer and estimation of HB VDL by real time PCR. Results: Fifty-three patients were HB e antigen (HBeAg)-positive, while
60 patients were HBeAg-negative. Mean total serum HB VDL was 2907.2±1060 IU/ml; 32 patients had low and 81 patients had high HB VDL. Mean total serum HBsAg level was 24.7±5.9x103 IU/ml. The ratio of the median log10 of serum HB VDL/ serum HBsAg level was 0.42 in low VDL patients and 0.4 in high VDL patients. Regression analysis defined high log10 of serum HBsAg level as the persistently significant determinant of cases with immune tolerance (IT) and/or immune reactive (IR), liver necrosis score, high log10 of serum VDL, the ratio of log10 values of serum VDL to serum HBsAg and male gender. ROC curve analysis defined high log10 of serum HBsAg level as a significant specific and the ratio of log10 of serum HB VDL to serum HBsAg as a significant sensitive predictor for IT cases and high log10 of serum HB VDL and positive HBeAg as significant predictors for presence of fibrosis. Conclusion: Quantitative estimation of serum level of HBsAg and viral load could differentiate between phases of CHB disease and predict histopathological status of the liver, so could spare liver biopsy with its inherent complications.