血清 HBsAg、HBV RNA、GGT 及 GPR 联合检测对慢性HBV感染自然史的诊断价值.

Objective To investigate the changes of serum hepatitis B virus surface antigen (HBsAg), hepatitis B virus ribonucleic acid (HBV RNA), γ-glutamyl transpeptidase (GGT), γ-glutamyl transpeptidase to platelet ratio (GPR) levels in patients with different stages of natural history of chronic hepatitis B virus (HBV) infection and the diagnostic value of combined detection in the staging of natural history of chronic HBV infection. Methods A total of 172 patients with chronic HBV infection who were not treated with antiviral therapy in the Third People’ s Hospital of Kunming from November 2020 to December 2023 were selected as the research objects. According to the process of HBV infection, they were divided into HBeAg-positive chronic HBV infection (EPI) group (n = 77), HBeAg-positive CHB (EPH) group (n = 42), HBeAg-negative chronic HBV infection (ENI) group (n = 26), HBeAg-negative CHB (ENH) group (n = 27). The differences of serum HBsAg, HBV RNA, GGT and GPR levels in each group were compared, and the receiver operating characteristic (ROC) curve was drawn to explore the diagnostic value of combined detection of serum HBsAg, HBV RNA, GGT and GPR in EPH and ENH stages in the natural history of chronic HBV infection. Results There were significant differences in serum HBsAg, HBV RNA, GGT and GPR levels among the four groups (P < 0.05). The area under the ROC curve (AUC) of combined detection of serum HBsAg, HBV RNA, GGT and GPR in the diagnosis of EPH and ENH was 0.869 and 0.836, respectively, and the sensitivity and specificity were 76.19%, 59.26% and 84.42%, 96.15%, respectively. Conclusion The combined detection of serum HBsAg, HBV RNA, GGT and GPR has high accuracy and low misdiagnosis rate in the diagnosis of natural history of chronic HBV infection, which is expected to replace the traditional invasive examination. It plays an important clinical significance in the accurate diagnosis and individualized treatment strategy of patients with a natural history of chronic HBV infection. [ABSTRACT FROM AUTHOR]