title: Clinical Significance of Quantitative HBsAg Titres and its Correlation With HBV DNA Levels in the Natural History of Hepatitis B Virus Infection.
abstract: OBJECTIVE
  Quantification of serum hepatitis B antigen (HBsAg) is an important test that marks active infection with hepatitis B and helps in the prediction of the clinical outcome and management of hepatitis B virus (HBV) infection. Correlation with HBV DNA quantitative levels may help in developing strategies for antiviral treatment. This study is aimed to evaluate HBsAg titres in various phase of HBV infection in HBsAg positive patients, and its correlation with HBV DNA viral load levels.
  
  
  METHODS
  976 HBV related patients were analysed in this retrospective cross-sectional study. Patients were categorised on the basis of the phase of HBV infection: immune tolerant phase (IT,n= 123), immune clearance phase (IC,n= 192), low-replicative phase (LR,n= 476), and HBeAg-negative hepatitis (ENH,n= 185). HBsAg titres were quantified and correlated with HBV-DNA levels and clinical parameters.
  
  
  RESULTS
  Median HBsAg titres were different between each phases of HBV infection (P< 0.001): (4.62 log10 IU/ml), IC (3.88 log10 IU/ml), LR (2.76 log10 IU/ml) and ENH (2.94 log10 IU/ml). HBsAg and HBV DNA levels showed significant correlation in the whole group (r= 0.694,P< 0.001), and this was also observed in different phases of HBV infection. Strong correlation in IT phase (r= 0.603,P< 0.001) and IC phase (r= 0.523,P< 0.001), moderate in LR phase (r= 0.362,P< 0.001) and weak in ENH (r= 0.110,P= 0.04). No correlation was observed between serum HBsAg levels and biochemical parameters.
  
  
  CONCLUSIONS
  The study demonstrated significant difference in the median baseline values of serum HBsAg titres in different phases of HBV infection and provides additional information in understanding the natural history of HBV-infection.
authors.affiliation: PCR Hepatitis Lab, Department of Medicine, Maulana Azad Medical College, University of Delhi, New Delhi 110002, India.
authors.forename: Vijay K
authors.initials: VK
authors.lastname: Karra
authors.affiliation: PCR Hepatitis Lab, Department of Medicine, Maulana Azad Medical College, University of Delhi, New Delhi 110002, India.
authors.forename: Soumya J
authors.initials: SJ
authors.lastname: Chowdhury
authors.affiliation: PCR Hepatitis Lab, Department of Medicine, Maulana Azad Medical College, University of Delhi, New Delhi 110002, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Ruttala
authors.affiliation: PCR Hepatitis Lab, Department of Medicine, Maulana Azad Medical College, University of Delhi, New Delhi 110002, India.
authors.forename: Sunil K
authors.initials: SK
authors.lastname: Polipalli
authors.affiliation: PCR Hepatitis Lab, Department of Medicine, Maulana Azad Medical College, University of Delhi, New Delhi 110002, India.
authors.forename: Premashis
authors.initials: P
authors.lastname: Kar
keywords: HBV DNA quantitative; HBV, hepatitis B virus; HBeAg; HBeAg, hepatitis B early antigen; HBsAg; IC, immune clearance phase; IT, immune tolerance phase; LR, low-replicative phase; hepatitis B virus; quantitative HBsAg