| Backgrounds and Objectives:Serum markers for chronic hepatitis B virus are playing a limited role in judging replication of HBV because the markers such as HBVDNA decrease to under detect limit quickly after treatment of nucleotides and can not be uased as therapeutic indicator of medical treatment.The recent study indicate that serum HBsAg quantitation not only reflects replication levels of HBV,but also has a correlation with cccDNA in hepatocyte.This study is designed to investigate clinical implication of HBsAg quantitation in patients treated with Lamivudine or Oxymatrine and the mechanism involved in their anti-HBV effects.Mehtods:63 untreated chronic HBV patients were randomly devided into two groups treated with Lamivudine or Oxymatrine.Abbot chemicals and automatic semi-quantitative flurenscence spectometery were applied to measure the serum titer of HBsAg at week 0,4,12,24 of treatment.Correlation of The HBsAg expression levels with ALT,HBVDNA,and age of patients through whole treatment was comprehensively analyzed in this study.Results:The complete therapeutic response rate from Oxymatrine(19.4%) was not significantly higher than that of Lamivudine(6.25%).The negative conversion rate of HBV DNA in Lamivudine group(93.75%,30/32) was significantly higher than that of Oxymatrine(29%,9/31)(x~2=27.9655,P=0.0001).The negative conversion rates of HBeAg in Oxymatrine and Lamivudine groups were 38.7%(13/31) and 18.8%(6/32) respectively,and their serum conversion rates were 19.4%(6/31) and 6.25%(2/32) respectively,statistical analysis shows significant difference between the two groups(x ~2=4.0168,P=0.0450).No significant difference was detected in ALT normalization rate between Lamivudine group(68.8%,22/32) and Oxymatrine group(58.1%,18/31)(x ~2=0.7756,P=0.3785).The serum titers of HBsAg was positively correlated with HBVDNA(r=0.34848578,p=0.0051),negatively related to ages of patients(r=-0.356, p=0.042),and not associated with serum ALT levels(r=-1.1861,p=0.2402) prior to the treatment.After the initiation of the treatment,Oxymatrine decreased HBsAg levels from 315.5±49.1(31) to 237.9±43.3(6) rapidly and obviously after one month treatment,while Lamivudine slowly reduced the HBsAg levels from 317.1±74.6(32) to 333.7±37.5(6).At the end of treatment,HBsAg levels were significantly lower in Oxymatrine group than Lamivudine group(p＜0.0001),HBsAg levels in 77.4%patients trated with Oxymatrine were less than 100S/N compared with 12.5%patients treated with Lamivudine.Complete response rates of patients with HBsAg levels less than 200S/N,200-300S/N,more than 300S/N were 50.0%,15.0%,7.7%respectively. Genearally,patients with complete response rates had significantly lower HBsAg levels (271.81±43.62) than patients with non-complete response rates(320.66±55.67) prior to treatment(p=0.0209),which manifested in both Lamivudine group and Oxymatrine group.In treatment week 4,sharp decline of HBsAg in Oxymatrine group is supposed to be related to it's high therapeutic response rate.Conclusion:Quantitation of HBsAg can reflect the replication levels of HBV and predict the therapeutic response rate.The difference of HBsAg levels after treatment with Oxymatrine or Lamivudine suggests more than one anti-virus mechanisms are involved.
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