The Dynamic Monitoring Of HbsAg Quantification In The Disease Progression After Chronic HBV Infection

Objective To investigate the clinical value of HBs Ag quantification in dynamic monitoring of disease progression in patients with chronic HBV infection.Methods A retrospective analysis was performed for the clinical data of 1107 patients with different clinical stages of chronic HBV infection who had not received antiviral therapy at the time of treatment in our hospital from May 2011 to December 2015,and according to the disease status,they were divided into HBe Ag-positive chronic hepatitis B(CHB)group(n=356),HBe Ag-negative CHB group(n=264),compensated liver cirrhosis group(LC-C group,n=116),decompensated liver cirrhosis group(LC-D group,n=201),and primary liver cancer(PLC)group(n=170).These groups were compared in terms of HBs Ag expression and the association between HBs Ag and clinical features.An analysis of variance was used for comparison of continuous data between multiple groups,and the least significant difference t-test was used for further comparison between any two groups;t-test was used for comparison of continuous data between two groups.The chi-square test was used for comparison of categorical data between these groups.Pearson correlation analysis was also performed.Results1.There were significant differences in serum HBs Ag and HBV DNA level between the HBe Ag-positive CHB group,HBe Ag-negative CHB group,LC-C group,LC-D group,and PLC group(F=100.45 and 86.26,both P<0.001),the HBs Ag level was highest in the HBe Ag-positive CHB group,the LC-C group was the second,and the PLC group was the lowest.2.The HBe Ag-positive CHB group(n=502)had significantly higher levels of HBs Ag and HBV DNA than the HBe Ag-negative CHB group(n=605)(t=16.67 and 16.22,both P<0.001).There were significant differences in HBs Ag and HBV DNA levels between the HBe Ag-positive CHB group,LC-C group,LC-D group,and PLC group(F=42.92 and 27.38,both P<0.001),as well as between the HBe Ag-negative CHB group,LC-C group,LC-D group,and PLC group(F=6.04 and 4.10,both P<0.05).3.The HBs Ag level of HBV infection in the overall sample was negatively correlated with age(r=-0.55,P<0.001).The HBs Ag level in HBe Ag-positive and HBe Ag-negative patients was also negatively correlated with age(r=-0.166,-0.380,respectively,P values were <0.001).4.HBV DNA level was significantly different across patients with different HBs Ag levels(<1000 IU/ml,1000-20 000 IU/ml,and>20 000 IU/ml)(F=189.51,P<0.001).In the HBe Ag-positive CHB group,HBe Ag-negative CHB group,LC-C group,and LC-D group,serum HBs Ag level was positively correlated with HBV DNA level(r=0.554,0.501,0.320,and 0.432,all P<0.001);there was no correlation between HBs Ag and HBV DNA level in the PLC group(r=0.081,P=0.411).Conclusion HBs Ag level decreased gradually with the progression of HBV infection and is closely associated with HBV DNA level.Dynamic monitoring of HBs Ag level helps to evaluate disease progression after HBV infection.