title: Comparison of hepatitis B surface antigen and e antigen in predicting liver histology in hepatitis B e antigen-positive chronic hepatitis B patients.
abstract: OBJECTIVE
  The purpose of this study was to determine the relationship between hepatitis B e antigen (HBeAg) and hepatitis B surface antigen (HBsAg) levels and liver histology in HBeAg-positive patients with chronic hepatitis B virus (CHB) infection.
  
  
  METHODS
  Serum HBsAg and HBeAg levels were analyzed, and liver biopsies were obtained from 203 HBeAg-positive CHB patients (62.6 % males; median age 31.3 years). The upper limit of normal (ULN) for ALT in this study was 30 and 19 U/L for males and females, respectively. Histologic assessment was based on Scheuer classification.
  
  
  RESULTS
  ALT <2 × ULN, fibrosis stage <S2, and necro-inflammation grade <G2 were noted in 70 (34.5 %), 141 (69.5 %), and 105 (51.7 %) patients, respectively. Patients with significant histology (fibrosis stage ≥S2 and/or fibrosis stage of 1 plus inflammation grade ≥2) had significantly lower median HBsAg (13,998.4 and 42,186.5 IU/mL, respectively, p < 0.001) and HBeAg levels (540.5 and 1,206.8 S/CO, respectively, p < 0.001) than patients with insignificant histology. Among patients with ALT <2 × ULN, the area under the ROC curve for serum HBsAg and HBeAg levels was 0.76 and 0.70, respectively. Using a cutoff value of 17,558 IU/mL for HBsAg and 875.6 S/CO for HBeAg in patients with ALT <2×ULN, positive predictive values for insignificant histology were 87 and 86.8 %, respectively, whereas the negative predictive values were 50 and 47.1 %, respectively.
  
  
  CONCLUSIONS
  Among HBeAg-positive patients with ALT <2 × ULN, high-serum HBsAg and HBeAg levels can equally accurately predict insignificant histology.
authors.affiliation: Department of Infectious Diseases, Zhejiang People's Provincial Hospital, No. 108, Shan Tang Road, Hangzhou, 310016, Zhejiang, China. hongwang71@yahoo.com.
authors.forename: Hong
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Infectious Diseases, Zhejiang People's Provincial Hospital, No. 108, Shan Tang Road, Hangzhou, 310016, Zhejiang, China. rosy@163.com.
authors.forename: Rong
authors.initials: R
authors.lastname: Yan
authors.affiliation: Department of Infectious Diseases, Zhejiang People's Provincial Hospital, No. 108, Shan Tang Road, Hangzhou, 310016, Zhejiang, China. yinzhou@163.com.
authors.forename: Yin
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Infectious Diseases, Zhejiang People's Provincial Hospital, No. 108, Shan Tang Road, Hangzhou, 310016, Zhejiang, China. mingshangwang@163.com.
authors.forename: Ming Shan
authors.initials: MS
authors.lastname: Wang
authors.affiliation: Department of Pathology, Zhejiang People's Provincial Hospital, No. 108, Shan Tang Road, Hangzhou, 310016, Zhejiang, China. rouguoqing@163.com.
authors.forename: Guo Qin
authors.initials: GQ
authors.lastname: Ruo
authors.affiliation: Department of Infectious Diseases, Zhejiang People's Provincial Hospital, No. 108, Shan Tang Road, Hangzhou, 310016, Zhejiang, China. meijuanchen@163.com.
authors.forename: Mei Juan
authors.initials: MJ
authors.lastname: Cheng
keywords: Aminotransferase; Biopsy; Hepatitis B e antigen; Hepatitis B surface antigen; Hepatitis B virus; Liver fibrosis