title: Role of serum hepatitis B virus marker quantitation to differentiate natural history phases of HBV infection.
abstract: OBJECTIVE
  The purpose of this study was to characterize roles of serum hepatitis B virus marker quantitation in differentiation of natural phases of HBV infection.
  
  
  METHODS
  A total of 184 chronic hepatitis B (CHB) patients were analyzed retrospectively. Patients were classified into four categories: immune tolerant phase (IT, n = 36), immune clearance phase (IC, n = 81), low-replicative phase (LR, n = 31), and HBeAg-negative hepatitis phase (ENH, n = 36), based on clinical, biochemical, serological, HBV DNA level and histological data.
  
  
  RESULTS
  Hepatitis B surface antigen (HBsAg) quantitation in four phases were 4.7 ± 0.2, 3.8 ± 0.5, 2.5 ± 1.2 and 3.4 ± 0.4 log10 IU/mL, respectively. There were significant differences between IT and IC (p < 0.001) and between LR and ENH phases (p < 0.001). Quantitation of hepatitis B e antigen (HBeAg) in IT and IC phases are 1317.9 ± 332.9 and 673.4 ± 562.1 S/CO, respectively (p < 0.001). Hepatitis B core antibody (HBcAb) quantitation in the four groups were 9.48 ± 3.3, 11.7 ± 2.8, 11.2 ± 2.6 and 13.2 ± 2.9 S/CO, respectively. Area under receiver operating characteristic curve (AUCs) of HBsAg and HBeAg at cutoff values of 4.41 log10 IU/mL and 1118.96 S/CO for differentiation of IT and IC phases are 0.984 and 0.828, with sensitivity 94.4 and 85.2 %, specificity 98.7 and 75 %, respectively. AUCs of HBsAg and HBcAb at cutoff values of 3.4 log10 IU/mL and 10.5 S/CO for differentiation of LR and ENT phases are 0.796 and 0.705, with sensitivity 58.1 and 85.7 %, and specificity 94.4 and 46.2 %, respectively.
  
  
  CONCLUSIONS
  HBsAg quantitation has high predictive value and HBeAg quantitation has moderate predictive value for discriminating IT and IC phase. HBsAg and HBcAb quantitations have moderate predictive values for differentiation of LR and ENH phase.
authors.affiliation: Infectious Disease Hospital of Yantai, 62 Huanshan Road, Zhifu District, Yantai, 264001, Shandong, China. liliwang2200@163.com.
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.affiliation: Infectious Disease Hospital of Yantai, 62 Huanshan Road, Zhifu District, Yantai, 264001, Shandong, China.
authors.forename: Zhi-Qiang
authors.initials: ZQ
authors.lastname: Zou
authors.affiliation: Hepatology Department, Qilu Hospital Affiliated to Shandong University, Jinan, Shandong, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Wang
authors.affiliation: Infectious Disease Hospital of Yantai, 62 Huanshan Road, Zhifu District, Yantai, 264001, Shandong, China.
authors.forename: Ji-Guang
authors.initials: JG
authors.lastname: Yu
authors.affiliation: Infectious Disease Hospital of Yantai, 62 Huanshan Road, Zhifu District, Yantai, 264001, Shandong, China.
authors.forename: Xiang-Zhong
authors.initials: XZ
authors.lastname: Liu
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000943:Antigens, Differentiation / Q000276:immunology; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000097:blood* / Q000276:immunology; D006513:Hepatitis B e Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D019694:Hepatitis B, Chronic / Q000097:blood* / Q000175:diagnosis / Q000276:immunology; D006801:Humans; D007108:Immune Tolerance / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D019562:Viral Load
chemical_list: D000943:Antigens, Differentiation; D015415:Biomarkers; D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: Differentiation; Hepatitis B virus marker; Infection; Natural history; Quantitation