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Background A minimally invasive tool to promptly predict hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) is currently needed. In this study, we aimed via a meta-analysis to identify the serum Mac-2 binding protein glycosylation isomer (M2BPGi) as a novel glycoproteinbased liver fibrosis marker for predicting HCC in CHB patients. Methods We conducted a systematic search on PubMed, Scopus, ProQuest, Wiley Online Library, and CINAHL Plus (via EBSCOhost). The articles were screened based on several eligibility criteria and were further assessed for study qualities using the Newcastle-Ottawa Scale. The outcomes were presented as standard mean difference (SMD), hazard ratio (HR), and predictive accuracy parameters of a baseline cutoff index (COI) for serum M2BPGi. Results Fourteen studies involving 5918 CHB patients were included in this systematic review and meta-analysis. Baseline COI serum M2BPGi was significantly higher in CHB patients who developed HCC than in those who did not (SMD 1.32, 95% confidence interval [CI] 0.91-1.72). A significant HCC risk prediction was also observed (multivariate HR 1.18, 95%CI 1.05-1.32). Baseline COI serum M2BPGi could predict HCC with a pooled sensitivity of 74% (95%CI 50-89%), specificity of 80% (95%CI 65-90%), and area under the summary receiver operating characteristic curve of 0.84 (95%CI 0.81-0.87). Conclusion High baseline COI serum M2BPGi may predict the development of HCC in CHB patients with moderate-to-high accuracy. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the profile of qHBs Ag profile, and also to investigate the correlation between qHBs Ag and HBV DNA. Seventy samples of chronic-naïve hepatitis B patients in Dr. Soetomo Hospital were analyzed in a cross-sectional study. Patients were categorized according to the HBe Ag positive (n=30) and HBe Ag negative (n=18), also based on qHBs Ag 1000 IU/mL and qHBs Ag >1000 IU/mL. qHBs Ag was correlated with HBV DNA. qHBs Ag by CLEIA method from Sysmex, KOBE HISCL, HBV DNA was measured by real-time Polymerase Chain method from Gene Xpert, Cepheid. 70 patients naïve CHB treatment showed a median of ALT level 60.21±70.76 U/L. 30 patients showed a positive-HBeAg, 18 patients showed negative-HBeAg, 22 patients were not evaluated (N/A). Positive-HBeAg patients had 70% qHBsAg >2500 mg/dL and median HBV DNA 7.49×107 IU/mL. Negative-HBeAg patients had 55.6% HBsAg ≤1000 mg/dL and median HBV DNA 9.66×102 IU/mL. qHBsAg correlated with HBV DNA (p <0.001). This data demonstrated that quantitative HBsAg was associated with a phase of HBV-infection, quantitative HBsAg showed a moderate correlation with DNA HBV, quantitative HBsAg levels might be a predictor of initiation therapy for CHB patients. [ABSTRACT FROM AUTHOR]

Background: The data of lower quantitative hepatitis B surface antigen (HBsAg) level were associated with more severe liver fibrosis in HBeAg-positive chronic hepatitis B. This study aimed to analyze correlation between liver fibrosis based on transient elastography and quantitative HBsAg levels in HBeAg-positive chronic hepatitis B patients. Methods: We conducted a cross-sectional study of 32 treatment-naive HBeAg-positive chronic hepatitis B patients. Liver fibrosis was measured using transient elastography, and quantitative HBsAg level was measured using automated Chemiluminescence Enzyme Immunoassay. Results: Quantitative HBsAg levels were highest in the F1 group, followed by F2, F3 and lowest in the F4 group. A strong negative correlation between transient elastography and quantitative HBsAg level was revealed in HBeAg-positive chronic hepatitis B patients (r=-0.706, p=0.000). Quantitative HBsAg levels were found to be higher in the immune-tolerant phase which liver fibrosis was minimal compared to the immune clearance phase which liver fibrosis was more severe. Patients with more severe liver fibrosis showed lower quantitative HBsAg levels. Conclusion: We found a negative correlation between liver fibrosis based on transient elastography and quantitative HBsAg levels in HBeAg-positive chronic hepatitis B. [ABSTRACT FROM AUTHOR]

Background: Chronic hepatitis B is a global burden disease with the mortality rate of over one million around the world because of the complication. In Indonesia the number of hepatitis B sufferers in a healthy population is estimated to reach 4-20.3%, where the figure is higher outside of Java. This study aims to analyze the description of HBeAg serological status in patients with chronic hepatitis B. Method: a descriptive study using medical records and sera of patients with chronic hepatitis B was used as primary data. The population of this study were patients with chronic hepatitis B in Gastroenterology and Hepatology Center of Dr. Soetomo General Hospital Surabaya in purposive sampling. The number of samples that fulfilled the inclusion and exclusion criteria was 82 people. Result: Most patients are between the ages of 50-59 (29,3%), males (67,1%), HbeAg loss (52,8%) receiving telbivudine (31,5%) and lamivudine (31,5%) as monotherapy for more than two years (42,1%) and have normal ALT (46,3%). Discussion: People with inactive (carriers) chronic HBsAg that are characterized by HBsAg last more than six months, also HBeAg negative, have serum ALT levels within normal limits. A temporary increase in ALT before remission can occur in some patients with chronic HBV infection after one year of treatment interruption. Conclusion: Telbivudine and lamivudine, separately as monotherapy, demonstrated greater HBeAg loss which reached within more than two years therapy. [ABSTRACT FROM AUTHOR]

A 45-year man with a chronic hepatitis B virus (HBV) infection, elevated alphafetoprotein (AFP) 628ng/dL and Abdominal CT-scan features of Hepatocellular Carcinoma was admitted with polycythemia condition (haemoglobin 20.4g/dL, haematocrit 65.4%). Elevated of erythropoietin (EPO) serum level confirmed the polycythemia was because of hepatocellular carcinoma (HCC) as a paraneoplastic syndrome. Based on diganosis criteria of HCC by Indonesian Association for the Study of the Liver 2017, the patient was diagnosed with HCC Barcelona clinic liver cancer (BCLC) B and was treated with trans arterial chemotherapy and embolization (TACE) with mixed doxorubicin. Aspirin 80mg once daily was given to patient to prevent thrombosis event. One month later after TACE, haemoglobin and haematocrite didn't improve. Then 4 months later the patient died of cardiovascular event in the last admission at district hospital. [ABSTRACT FROM AUTHOR]

The prevalence of hepatitis B infection in Indonesia is still alarming, while its therapies cannot eradicate the virus and only aim for long term viral suppression. Hepatitis B surface antigen (HBsAg) quantification has become an emphasis on researches, regarding its capacity to identify the natural history of hepatitis B virus infection and predict the outcome of therapies. This review aims to determine the clinical role of HBsAg in chronic hepatitis B infection by reviewing textbooks, journal articles, and review articles without language restriction. This review finds that HBsAg is capable of predicting degrees of liver fibrosis severity in patients with chronic hepatitis B infection. Furthermore, HBsAg quantification can be used to distinguish inactive carriers from patients with HBeAg-negative chronic hepatitis B. The decrease of HBsAg is a good predictor of HBsAg loss, and it denotes discontinuation of nucleoside/nucleotide analog therapy. HBsAg quantification is also used in combined pegylated interferon (PEG-IFN) and nucleoside/nucleotide analog therapy. Nevertheless, this role is still controversial. Additionally, HBsAg cannot replace the major roles of hepatitis B virus deoxyribonucleic acid (HBV DNA) measurement in therapy management. Using either HBsAg or HBV DNA in therapy algorithm decreases its predictive value, hence recommendation to use both. In identifying patients with occult hepatitis B infection (OBI), HBV DNA still cannot be replaced by HBsAg quantification. Furthermore, HBsAg quantification may not be a good predictor of hepatocellular carcinoma in patients with OBI. Future studies are expected to demonstrate the role of HBsAg in current hepatitis B therapy and also future therapies. [ABSTRACT FROM AUTHOR]