The Analysis Of PreS1-Ag In Serum,HBVM And HBV-DNA Load Test Results In Children With Chronic HBV Infection

Objective To investigate the correlation between preS1-Ag and HBV DNA,HBVM in children with chronic HBV infection in our hospital between 2010 and 2016 and provide reference for clinical analysis.Methods There were 646 samples with hepatitis B virus markers abnormity.preS1-Ag,HBVM(HBV serological markers)and HBV-DNA load were detected and analyzed retrospectively.Results(1)In the 646 samples,421 were male and 225 were female.Male to female ratio was 1.87:1.There were 7 age groups.the positive rate of preS1-Ag 26%(5/19)was lower than the negative rate that74%(14/19)in 0-28 days age group(neonatal period).However,preS1-Ag positive rate were higher than the negative rate in groups which age more than 1 month old,of which 7-10ys group was88%(113/128),1-3ys group was the highest was 88%(113/129),followed by the 10-13ys group was 85%(95/112),the 4-6y age group was 82%(114/139),13-18ys old group was 81%(48/59),the lowest was 53%(32/60)of 1-12months group.The distribution of preS1-Ag positive rate was consistent with HBV-DNA level.In preS1-Ag positive group,the positive rate of HBV-DNA was89.3%in male samples(309/346),and 77.01%(134/174)in female,there was statistical significant difference between male and female.In preS1-Ag negative group,the positive rate of HBV-DNA in male and female children were 49.33%and 35.29%,and there was not statistical significant difference between male and female.(2)There were many varieties mode of serological pattern examined in the 646 samples with HBVM abnormal,the mode of"HBsAg(+)HBeAg(+)HBcAb(+)"was the highest detection rate66.09%(427/646),followed by"HBsAg(+)HbeAb(+)HbcAb(+)"mode 19.96%(128/646),and HBsAg(+)HBeAg(+)model5.26%(34/646),HBsAg(+)HBsAb(+)HBeAb(+)HBcAb(+)"1.39%(9/646),HBsAg(+)HBcAb(+)"mode0.77%(5/646),"HBsAb(+)HbeAb(+)HbcAb(+)"0.46%(3/646).preS1-Ag,HBV-DNA positive rate were different in the each HBVM model,which was in mode“HBsAg(+)HBeAg(+)HBcAb(+)”>model“HBsAg(+)HBeAg(+)”>model“HBs Ag(+)HBeAb(+)HBcAb(+)”,consistent with the infectious degree.The positive rate of preS1-Ag andHBV-DNAinHBeAg(+)groupwashigherthan HBeAg(-)group(P<0.01).(3)Both HBeAg and preS1-Ag can well judge the level and activity of HBV-DNA replication,but HBeAg was better than preS1-Ag.In the samples which HBV-DNA were positive and HBsAg titers were 0.05-100IU/ml,HBeAb(+)rate was higher than preS1positive rate(P=0.00~a).In the serum samples which HBsAg titers were more than 100IU/ml,HBeAb positive and preS1-Ag positive rate had no significant difference(P>0.05).When HBsAg>10000IU/ml,HBV-DNA and HBsAg were consistent well(P=0.004,R=0.69).(4)There was no significant difference in HBV-DNA load between gender(P=0.27).HBV-DNA average load in preS1-Ag positive samples was higher than that of preS1-Ag negative samples(P=0.00).Both HBeAg and preS1-Ag positive samples,the mean HBV-DNA load was higher than that of HBeAg positive,preS1-Ag negative samples.HBV-DNA load in the HBeAg negative,preS1-Ag positive group was higher than the preS1-Ag negative group,but the difference was not statistical significance.When HBV-DNA>10~6copies/ml,the positive rate of HBeAg was higher than that of preS1-Ag(P=0.005).The positive rate of PreS1-Ag in the"HBV-DNA>10~6 copies/ml"group was higher than the"10~3 copies/ml-10~6 copies/ml"group(78.8%)(P<0.01).The positive rate of PreS1-Ag in the HBV-DNA"10~3 copies/ml-10~6 copies/ml"group was higher than that of the<10~3copies/ml group(52.1%)(P<0.01).Conclusion(1)When children with HBV markers abnormal more than 1month old,the positive rate of preS1-Ag was higher than the negative rate,consistent with the distribution of HBV-DNA.(2)In HBV-DNA positive group,preS1-Ag positive rate con sistent with the degree of infectivity,"HBsAg(+)HBeAg(+)HBcAb(+)">"HBsAg(+)HBeAg(+)">HBsAg(+)HBeAb(+)HBcAb(+)".(3)In preS1-Ag positive children,the positive rate of HBV-DNA which were male was significantly higher than that in female.HBV-DNA load was not relevant to gender.HBV-DNA load in HBeAg positive children were higher than that in HBeAg negative children,HBV-DNA loadin both HBeAg and preS1-Ag positive children was higher than HBeAg positive,preS1-Ag negative children.(4)Both HBeAg and preS1-Ag can react HBV-DNA replication activity,combination of the two to predict HBV-DNA level was better than either of them.The value of HBe Ag has more infection sensitivity and higher specificity than preS1-Ag.HBeAg quantitative was negatively related to age,and preS1-Ag antigen may be more suitable to react HBV replication than e antigen in elder children.(5)HBs Ag,HBeAg and HBV-DNA have a good correlation,but the correlation between HBeAg and HBV-DNA was stronger.HBV-DNA and preS1-Ag were better correlation when HBsAg titer>10000IU/ml.(6)preS1-Ag antigen plays an important role in the patients with e antigen or HBV-DNA negative.