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Zhang P, Du HB, Tong GD, Li XK, Sun XH, Chi XL, Xing YF, Zhou ZH, Li Q, Chen B, Wang H, Wang L, Jin H, Mao DW, Wang XB, Wu QK, Li FP, Hu XY, Lu BJ, Yang ZY, Zhang MX, Shi WB, He Q, Li Y, Jiang KP, Xue JD, Li XD, Jiang JM, Lu W, Tian GJ, Hu ZB, Guo JC, Li CZ, Deng X, Luo XL, Li FY, Zhang XW, Zheng YJ, Zhao G, Wang LC, Wu JH, Guo H, Mi YQ, Gong ZJ, Wang CB, Jiang F, Guo P, Yang XZ, Shi WQ, Yang HZ, Zhou Y, Sun NN, Jiao YT, Gao YQ, Zhou DQ, Ye YA. Serum hepatitis B surface antigen correlates with fibrosis and necroinflammation: A multicentre perspective in China. J Viral Hepat 2018; 25:1017-1025. [PMID: 29624802 DOI: 10.1111/jvh.12903] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 02/22/2018] [Indexed: 12/20/2022]
Abstract
The kinetics of serum hepatitis B surface antigen (HBsAg) during the natural history of hepatitis B virus (HBV) infection has been studied, but the factors affecting them remain unclear. We aimed to investigate the factors affecting HBsAg titres, using data from multicentre, large-sized clinical trials in China. The baseline data of 1795 patients in 3 multicentre trials were studied, and the patients were classified into 3 groups: hepatitis B early antigen (HBeAg)-positive chronic HBV infection (n = 588), HBeAg-positive chronic hepatitis B (n = 596), and HBeAg-negative chronic hepatitis B (n = 611). HBsAg titres in the different phases were compared, and multiple linear progression analyses were performed to investigate the implicated factors. HBsAg titres varied significantly in different phases (P = .000), with the highest (4.60 log10 IU/mL [10%-90% confidence interval: 3.52 log10 IU/mL-4.99 log10 IU/mL]) in patients with HBeAg-positive chronic HBV infection. In all phases, age and HBV DNA were correlated with serum HBsAg level. In HBeAg-positive chronic hepatitis B patients, a negative correlation between HBsAg titres and fibrosis stage was observed. Alanine amonitransferase or necroinflammatory activity was also correlated with HBsAg titres in HBeAg-negative chronic hepatitis B patients. In conclusion, decreased HBsAg titres may be associated with advancing fibrosis in HBeAg-positive chronic hepatitis B patients or increased necroinflammation in those with HBeAg-negative chronic hepatitis B. Our findings may help clinicians better understand the kinetics of HBsAg and provide useful insights into the management of this disease.
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Affiliation(s)
- P Zhang
- Department of Gastroenterology and Hepatology, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China.,Institute of liver disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - H B Du
- Department of Gastroenterology and Hepatology, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China.,Institute of liver disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - G D Tong
- Department of Hepatology, Shenzhen Hospital of Traditional Chinese Medicine, Shenzhen, Guangdong Province, China
| | - X K Li
- Department of Gastroenterology and Hepatology, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China.,Institute of liver disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - X H Sun
- Department of Hepatology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - X L Chi
- Department of Hepatology, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Y F Xing
- Department of Hepatology, Shenzhen Hospital of Traditional Chinese Medicine, Shenzhen, Guangdong Province, China
| | - Z H Zhou
- Department of Hepatology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Q Li
- The Fourth Ward, Fuzhou Infectious Disease Hospital, Fuzhou, Fujian Province, China
| | - B Chen
- Department of Hepatology, The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan Province, China
| | - H Wang
- Department of Infectious Disease, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - L Wang
- Department of Hepatology, Chengdu Infectious Disease Hospital, Chengdu, Sichuan Province, China
| | - H Jin
- Department of Integrated Traditional and Western Medicine on Liver Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - D W Mao
- Department of Hepatology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, Guangxi Province, China
| | - X B Wang
- Department of Integrated Traditional and Western Medicine on Liver Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Q K Wu
- The First Department of Hepatology, Shenzhen No. 3 People's Hospital, Shenzhen, Guangdong Province, China
| | - F P Li
- Department of Hepatology, Shanxi Hospital of Traditional Chinese Medicine, Xi'an, Shanxi Province, China
| | - X Y Hu
- Department of Infectious Disease, The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - B J Lu
- Department of Hepatology, The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning Province, China
| | - Z Y Yang
- Department of Integrated Traditional and Western Medicine on Liver Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - M X Zhang
- Department of Integrated Traditional and Western Medicine on Liver Diseases, Shenyang Infectious Disease Hospital, Shenyang, Liaoning Province, China
| | - W B Shi
- Department of Infectious Disease, The First Affiliated Hospital of Anhui Academy of Chinese Medicine, Hefei, Anhui Province, China
| | - Q He
- The First Department of Hepatology, Shenzhen No. 3 People's Hospital, Shenzhen, Guangdong Province, China
| | - Y Li
- Department of Hepatology, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - K P Jiang
- Department of Hepatology, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong Province, China
| | - J D Xue
- Department of Hepatology, Shanxi Hospital of Traditional Chinese Medicine, Xi'an, Shanxi Province, China
| | - X D Li
- Department of Hepatology, Hubei Province Hospital of Traditional Chinese Medicine, Wuhan, Hubei Province, China
| | - J M Jiang
- Department of Hepatology, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong Province, China
| | - W Lu
- Department of Infectious Disease, Tianjin Infectious Disease Hospital, Tianjin, China
| | - G J Tian
- Department of Hepatology, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Z B Hu
- Department of Hepatology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, Guangxi Province, China
| | - J C Guo
- Department of Hepatology, Hangzhou No. 6 People's Hospital, Hangzhou, Zhejiang Province, China
| | - C Z Li
- Department of Infectious Disease, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - X Deng
- Department of Hepatology, Ruikang Hospital, Guangxi University of Chinese Medicine, Nanning, Guangxi Province, China
| | - X L Luo
- Department of Hepatology, Hubei Province Hospital of Traditional Chinese Medicine, Wuhan, Hubei Province, China
| | - F Y Li
- Treatment and Research Center of Infectious Disease, 302 Military Hospital of China, Beijing, China
| | - X W Zhang
- Treatment and Research Center of Infectious Disease, 302 Military Hospital of China, Beijing, China
| | - Y J Zheng
- Department of Hepatology, Shenzhen Hospital of Traditional Chinese Medicine, Shenzhen, Guangdong Province, China
| | - G Zhao
- Department of Hepatology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - L C Wang
- Center of Infectious Disease, Huaxi Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - J H Wu
- Center of Hepatology, Xiamen Hospital of Traditional Chinese Medicine, Xiamen, Fujian Province, China
| | - H Guo
- Department of Hepatology, The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Y Q Mi
- Department of Infectious Disease, Tianjin Infectious Disease Hospital, Tianjin, China
| | - Z J Gong
- Department of Infectious Disease, Hubei People's Hospital, Wuhan, Hubei Province, China
| | - C B Wang
- The Fourth Department of Infectious Disease, Linyi People's Hospital, Linyi, Shandong Province, China
| | - F Jiang
- Department of Gastroenterology and Hepatology, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China.,Institute of liver disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - P Guo
- Department of Hepatology, Xiyuan Hospital, China Academy of Chinese medical Science, Beijing, China
| | - X Z Yang
- Institute of liver disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China.,Department of Infectious Disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - W Q Shi
- Department of Hepatology, Xinhua Hospital, Zhejiang University of Traditional Chinese medicine, Hangzhou, Zhejiang Province, China
| | - H Z Yang
- Department of Traditional Chinese medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Y Zhou
- Department of Hepatology, Qingdao No. 6 People's Hospital, Qingdao, Shandong Province, China
| | - N N Sun
- Department of Hepatology, Beijing Hospital of Traditional Chinese Medicine, Beijing, China
| | - Y T Jiao
- Shunyi Hospital of Traditional Chinese Medicine, Beijing, China
| | - Y Q Gao
- Department of Hepatology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - D Q Zhou
- Department of Hepatology, Shenzhen Hospital of Traditional Chinese Medicine, Shenzhen, Guangdong Province, China
| | - Y A Ye
- Department of Gastroenterology and Hepatology, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China.,Institute of liver disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
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