title: Hepatitis B surface antigen levels during natural history of chronic hepatitis B: a Chinese perspective study.
abstract: OBJECTIVE
  To determine the baseline hepatitis B surface antigen (HBsAg) levels during the different phases of chronic hepatitis B (CHB) patients in China.
  
  
  METHODS
  Six hundred and twenty-three hepatitis B virus or un-infected patients not receiving antiviral therapy were analyzed in a cross-sectional study. The CHB patients were classified into five phases: immune-tolerant (IT, n = 108), immune-clearance (IC, n = 161), hepatitis B e antigen negative hepatitis (ENH, n = 149), low-replicative (LR, n = 135), and liver cirrhosis (LC, n = 70). HBsAg was quantified (Abbott ARCHITECT assay) and correlated with hepatitis B virus (HBV) DNA, and serum alanine aminotransferase/aspartate aminotransferase (ALT/AST) in each phase of CHB was also determined.
  
  
  RESULTS
  Median HBsAg titers were different in each phase of CHB (P < 0.001): IT (4.85 log10 IU/mL), IC (4.36 log10 IU/mL), ENH (2.95 log10 IU/mL), LR (3.18 log10 IU/mL) and LC (2.69 log10 IU/mL). HBsAg titers were highest in the IT phase and lowest in the LC phase. Serum HBsAg titers showed a strong correlation with HBV viral load in the IC phase (r = 0.683, P < 0.001). No correlation between serum HBsAg level and ALT/AST was observed.
  
  
  CONCLUSIONS
  The mean baseline HBsAg levels differ significantly during the five phases of CHB, providing evidence on the natural history of HBV infection. HBsAg quantification may predict the effects of immune-modulator or oral nucleos(t)ide analogue therapy.
authors.affiliation: Lin-Yan Zeng, Jiang-Shan Lian, Jian-Yang Chen, Hong-Yu Jia, Yi-Min Zhang, Dai-Rong Xiang, Liang Yu, Jian-Hua Hu, Ying-Feng Lu, Lin Zheng, Lan-Juan Li, Yi-Da Yang, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Lin-Yan
authors.initials: LY
authors.lastname: Zeng
authors.affiliation: Lin-Yan Zeng, Jiang-Shan Lian, Jian-Yang Chen, Hong-Yu Jia, Yi-Min Zhang, Dai-Rong Xiang, Liang Yu, Jian-Hua Hu, Ying-Feng Lu, Lin Zheng, Lan-Juan Li, Yi-Da Yang, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Jiang-Shan
authors.initials: JS
authors.lastname: Lian
authors.affiliation: Lin-Yan Zeng, Jiang-Shan Lian, Jian-Yang Chen, Hong-Yu Jia, Yi-Min Zhang, Dai-Rong Xiang, Liang Yu, Jian-Hua Hu, Ying-Feng Lu, Lin Zheng, Lan-Juan Li, Yi-Da Yang, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Jian-Yang
authors.initials: JY
authors.lastname: Chen
authors.affiliation: Lin-Yan Zeng, Jiang-Shan Lian, Jian-Yang Chen, Hong-Yu Jia, Yi-Min Zhang, Dai-Rong Xiang, Liang Yu, Jian-Hua Hu, Ying-Feng Lu, Lin Zheng, Lan-Juan Li, Yi-Da Yang, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Hong-Yu
authors.initials: HY
authors.lastname: Jia
authors.affiliation: Lin-Yan Zeng, Jiang-Shan Lian, Jian-Yang Chen, Hong-Yu Jia, Yi-Min Zhang, Dai-Rong Xiang, Liang Yu, Jian-Hua Hu, Ying-Feng Lu, Lin Zheng, Lan-Juan Li, Yi-Da Yang, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Yi-Min
authors.initials: YM
authors.lastname: Zhang
authors.affiliation: Lin-Yan Zeng, Jiang-Shan Lian, Jian-Yang Chen, Hong-Yu Jia, Yi-Min Zhang, Dai-Rong Xiang, Liang Yu, Jian-Hua Hu, Ying-Feng Lu, Lin Zheng, Lan-Juan Li, Yi-Da Yang, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Dai-Rong
authors.initials: DR
authors.lastname: Xiang
authors.affiliation: Lin-Yan Zeng, Jiang-Shan Lian, Jian-Yang Chen, Hong-Yu Jia, Yi-Min Zhang, Dai-Rong Xiang, Liang Yu, Jian-Hua Hu, Ying-Feng Lu, Lin Zheng, Lan-Juan Li, Yi-Da Yang, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Yu
authors.affiliation: Lin-Yan Zeng, Jiang-Shan Lian, Jian-Yang Chen, Hong-Yu Jia, Yi-Min Zhang, Dai-Rong Xiang, Liang Yu, Jian-Hua Hu, Ying-Feng Lu, Lin Zheng, Lan-Juan Li, Yi-Da Yang, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Hu
authors.affiliation: Lin-Yan Zeng, Jiang-Shan Lian, Jian-Yang Chen, Hong-Yu Jia, Yi-Min Zhang, Dai-Rong Xiang, Liang Yu, Jian-Hua Hu, Ying-Feng Lu, Lin Zheng, Lan-Juan Li, Yi-Da Yang, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Ying-Feng
authors.initials: YF
authors.lastname: Lu
authors.affiliation: Lin-Yan Zeng, Jiang-Shan Lian, Jian-Yang Chen, Hong-Yu Jia, Yi-Min Zhang, Dai-Rong Xiang, Liang Yu, Jian-Hua Hu, Ying-Feng Lu, Lin Zheng, Lan-Juan Li, Yi-Da Yang, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Zheng
authors.affiliation: Lin-Yan Zeng, Jiang-Shan Lian, Jian-Yang Chen, Hong-Yu Jia, Yi-Min Zhang, Dai-Rong Xiang, Liang Yu, Jian-Hua Hu, Ying-Feng Lu, Lin Zheng, Lan-Juan Li, Yi-Da Yang, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Lan-Juan
authors.initials: LJ
authors.lastname: Li
authors.affiliation: Lin-Yan Zeng, Jiang-Shan Lian, Jian-Yang Chen, Hong-Yu Jia, Yi-Min Zhang, Dai-Rong Xiang, Liang Yu, Jian-Hua Hu, Ying-Feng Lu, Lin Zheng, Lan-Juan Li, Yi-Da Yang, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Yi-Da
authors.initials: YD
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002681:China; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology*; D019694:Hepatitis B, Chronic / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors; D019562:Viral Load; D055815:Young Adult
chemical_list: D015415:Biomarkers; D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: Chronic hepatitis B; Hepatitis B surface antigen quantification; Natural history; Perspective
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