Quantitation Detection Of Hepatitis B Surface Antigen And Its Significance In Patients With Hepatic Cirrhosis

Object: To assess the change and clinical significance of the quantitation of HBsAg in HBV-associated hepatic cirrhosis.Method:Sixty HBV-associated hepatic cirrhosis patients were included in the study. The patients were divided into the compensated cirrhosis group (n=35) and the decompensated cirrhosis group (n=25) based on the diagnostic criteria of hepatitis determined at the 10th National Conference on Viral Hepatitis (Xi'an, September 2000). 45 asymptomatic healthy hepatitis B carriers were recruited as the control group. The serum titers of HBsAg and HBeAg were determined using electrochemiluminescence immunoassay(ECLIA), and HBV DNA load was measured using immunofluorescence quantitative polymerase chain reaction assay(PCR).Result:1. The chang of HBsAg level in the course of liver disease. In the carrier group, compensated cirrhosise group and decompensated cirrhosis group were 2574.73±3252.27 ng.ml-1,5494.35±2129.84 ng.ml-1 and 6921.25±1957.60 ng.ml-1, respectively. The differences among the three groups were statistically significant (p<0.05). So the HBsAg level was lower in the carrier group than in the compensated cirrhosise group and decompensated cirrhosis group, and the compensated cirrhosise group was lower than the decompensated cirrhosis group(p<0.05).2. The chang of HBeAg level in the course of liver disease. The HBeAg titer was the highest in asymptomatic HBV carriers, lower in the compensated cirrhosis group, and the lowest among the decompensated cirrhosis group. And only the difference between asymptomatic HBV carriers and the decompensated cirrhosis group was statistically significant (p<0.05).3. The chang of HBV DNA level in the course of liver disease. The mean level of HBV DNA load in the three group, the carrier group was higher than the two cirrhosis group(p<0.05), but there was no statistically significant between the compensated cirrhosis group and the decompensated cirrhosis group.4. The relationship between HBsAg and HBeAg. There were significantly reverse correlation between HBsAg and HBeAg in the carrier group and the compensated cirrhosis group(p<0.05), but HBsAg had no significant correlation with HBeAg in the decompensated cirrhosis group. 5. The relationship between HBsAg and HBV DNA. There was significantly reverse correlation between HBsAg and HBV DNA in the carrier group(p<0.05), but HBsAg had no significant correlation with HBV DNA in the compensated cirrhosis group and the decompensated cirrhosis group.Conclusion:1. With the progression of liver disease, a rising HBsAg gradient is observed.2. In the liver dease, virus replication is gradually weakened, the replication level is changed from high level to low level.3. In carrier group and compensated cirrhosis group, HBsAg is a indirect index to reflect viral replication, and HBsAg level has a significantly reverse correlation with HBeAg and HBV DNA in carrier group, and HBsAg level has a significantly reverse correlation with HBeAg in compensated cirrhosis group. HBsAg has no significant correlation with HBV DNA and HBeAg, suggesting that HBsAg does not reflect the activity of viral replication.