Quantitative serum HBV markers in predicting phases of natural history of chronic HBV infection

Highlights

• From EPIH to EPAH, HBsAg levels decrease steeply and anti-HBc levels increase steeply, and HBcrAg and HBV DNA levels decrease gently.

• From ENIH to ENAH, HBcrAg and HBV DNA and anti-HBc levels increase steeply, and HBsAg levels increase gently.

• Both HBsAg and anti-HBc for predicting EPAH and both HBV DNA and HBcrAg for predicting ENAH have good performances.

Abstract

Background

Clinical importance of commercially available quantitative HBV markers has not been fully investigated.

Objective

To choice and to evaluate clinically valuable HBV markers for predicting phases of natural history with chronic HBV infection.

Methods

472 naïve patients with chronic HBV infection were enrolled, in which 21 and 220 were confirmed as HBeAg-positive inactive and active hepatitis (EPIH and EPAH), respectively, and 106 and 125 were confirmed as HBeAg-negative inactive and active hepatitis (ENIH and ENAH), respectively. HBsAg, HBcrAg and anti- HBc were measured using chemiluminescent immunoassay, and HBV DNA was measured using PCR-fluorescence probing assay.

Results

There were all statistical differences in medians of HBsAg, anti-HBc, HBcrAg and HBV DNA between EPIH and EPAH and between ENIH and ENAH (all P < 0.01). According to binary logistic stepwise regressions, HBsAg and anti-HBc were preferred variables for predicting EPAH, and HBcrAg and HBV DNA were preferred variables for predicting ENAH. Based on normalization for coefficients of preferred variables entering regression equations, a handy model of MEPAH for predicting EPAH and of MENAH for predicting ENAH was constructed, respectively. Area under receiver operating characteristic curves of MEPAH and MENAH for predicting EPAH and ENAH were 0.882 and 0.931, respectively. With standard of MEPAH ≤ 5.997 and MENAH > 10.535, sensitivity or specificity of which for predicting EPAH and ENAH were about 81.0 % and 87.0 %, respectively.

Conclusion

HBsAg and anti-HBc for predicting EPAH and HBcrAg and HBV DNA for predicting ENAH are dependable markers; MEPAH for predicting EPAH and MENAH for predicting ENAH have very good performance.