title: Low Serum Hepatitis B Surface Antigen Level Predicts Compensated Cirrhosis Caused by Chronic Hepatitis B in HBeAg Positive Patients in East China.
abstract: BACKGROUND
  Serum hepatitis B surface antigen (HBsAg) levels are associated with fibrosis in patients with chronic hepatitis B (CHB) infection.
  
  
  OBJECTIVE
  The aim of our study was to evaluate serum HBsAg level as a biomarker for compensated cirrhosis in hepatitis B e antigen (HBeAg) positive CHB patients.
  
  
  METHODS
  Two-hundred and one HBeAg-positive Chinese CHB patients with or without cirrhosis were enrolled in this retrospective study. Cirrhosis was diagnosed based on liver biopsy. Furthermore, patients with decompensated cirrhosis were excluded. A statistical analysis was performed regarding the association between serum HBsAg level and compensated cirrhosis.
  
  
  RESULTS
  Patients with compensated cirrhosis had a significantly lower mean serum HBsAg level compared to those without cirrhosis (3.27 Log10 IU/mL VS 4.17 Log10 IU/mL, P < 0.001). Furthermore, examining the correlation with compensated cirrhosis revealed that lower level of serum HBsAg was a significant factor in multivariate analysis. The area under the receiver operating characteristics curve of serum HBsAg was 0.856 for compensated cirrhosis. A positive predictive value of 66.2% and negative predictive value of 90.7% were obtained with a cut-off value of < 3.60 Log10 IU/mL (4000 IU/mL) of serum HBsAg. Moreover, the rate of compensated cirrhosis increased to 75.0% after combining with APRI > 2.
  
  
  CONCLUSIONS
  In HBeAg positive CHB patients, low serum HBsAg level is a useful predictor of compensated cirrhosis.
authors: Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China ; Department of Infectious Diseases, Jing'An District Centre, Shanghai Hospital, Fudan University, Shanghai, China.
authors: Wen
authors: W
authors: Jia
authors: Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
authors: Xun
authors: X
authors: Qi
authors: Department of Infectious Diseases, Jing'An District Centre, Shanghai Hospital, Fudan University, Shanghai, China.
authors: Yan-Yan
authors: YY
authors: Ji
authors: Department of Liver Diseases, Xixi Hospital of Hangzhou, Zhejiang Chinese Medical University, Hangzhou, China.
authors: Yun-Hao
authors: YH
authors: Xun
authors: Department of Infectious Diseases, Jing'An District Centre, Shanghai Hospital, Fudan University, Shanghai, China.
authors: Hong
authors: H
authors: Wang
authors: Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China ; Department of Infectious Diseases, Jing'An District Centre, Shanghai Hospital, Fudan University, Shanghai, China.
authors: Wen-Hong
authors: WH
authors: Zhang
authors: Department of Infectious Diseases, Jing'An District Centre, Shanghai Hospital, Fudan University, Shanghai, China.
authors: Jian-Hua
authors: JH
authors: Yang
authors: Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
authors: Jin-Yu
authors: JY
authors: Wang
authors: Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
authors: Hao-Xiang
authors: HX
authors: Zhu
authors: Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
authors: Ri-Cheng
authors: RC
authors: Mao
authors: Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China ; Department of Infectious Diseases, Jing'An District Centre, Shanghai Hospital, Fudan University, Shanghai, China.
authors: Ji-Ming
authors: JM
authors: Zhang
keywords: Chronic; Hepatitis B; Hepatitis B Surface Antigens; Hepatitis B e Antigens; Liver Cirrhosis