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Hepatitis B Surface Antigen Levels Can Be Used to Rule Out Cirrhosis in Hepatitis B e Antigen-Positive Chronic Hepatitis B
- Source :
- Journal of Infectious Diseases, 225(11), 1967-1973. Oxford University Press
- Publication Year :
- 2022
- Publisher :
- Oxford University Press, 2022.
-
Abstract
- Background Serum hepatitis B surface antigen (HBsAg) levels correlate with the duration of chronic hepatitis B virus (HBV) infection and may predict the extent of hepatic fibrosis. Methods We analyzed data from the SONIC-B database, which contains data from 8 global randomized trials and 2 large hepatology centers. Relationship between HBsAg levels and presence of significant fibrosis (Ishak 3–4) or cirrhosis (Ishak 5–6) were explored, and clinically relevant cutoffs were identified to rule out cirrhosis. Results The dataset included 2779 patients: 1866 hepatitis B e antigen (HBeAg)-positive; 322 with cirrhosis. Among HBeAg-positive patients, lower HBsAg levels were associated with higher rates of significant fibrosis (odds ratio [OR], 0.419; P < .001) and cirrhosis (OR, 0.435; P < .001). No relationship was observed among HBeAg-negative patients. Among HBeAg-positive patients, genotype-specific HBsAg cutoffs had excellent negative predictive values (>97%) and low misclassification rates (≤7.1%) and may therefore have utility in ruling out cirrhosis. Diagnostic performance of the HBsAg cutoffs was comparable among patients in whom cirrhosis could not be ruled out with fibrosis 4 (FIB-4). Conclusions Hepatitis B virus genotype-specific HBsAg cutoffs may have utility in ruling out presence of cirrhosis in HBeAg-positive patients with genotypes B, C, and D and can be an adjunct to FIB-4 to reduce the need for further testing.
- Subjects :
- 0301 basic medicine
Liver Cirrhosis
medicine.medical_specialty
HBsAg
Hepatitis B virus
Cirrhosis
Gastroenterology
law.invention
03 medical and health sciences
0302 clinical medicine
Hepatitis B, Chronic
Randomized controlled trial
SDG 3 - Good Health and Well-being
Fibrosis
law
Internal medicine
medicine
Immunology and Allergy
Humans
Hepatitis B e Antigens
Hepatitis B Surface Antigens
business.industry
Odds ratio
Hepatitis B
Hepatology
medicine.disease
030104 developmental biology
Infectious Diseases
DNA, Viral
030211 gastroenterology & hepatology
Hepatic fibrosis
business
Subjects
Details
- Language :
- English
- ISSN :
- 15376613 and 00221899
- Volume :
- 225
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- Journal of Infectious Diseases
- Accession number :
- edsair.doi.dedup.....b95dfd0542e2a3f0550e5f34e7c07d9d