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Article: High hepatitis B surface antigen levels predict insignificant fibrosis in hepatitis B e antigen positive chronic hepatitis B
Title | High hepatitis B surface antigen levels predict insignificant fibrosis in hepatitis B e antigen positive chronic hepatitis B |
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Authors | |
Keywords | Accuracy Alanine aminotransferase blood level Diagnostic test accuracy study Disease severity Hepatitis B |
Issue Date | 2012 |
Publisher | Public Library of Science. The Journal's web site is located at http://www.plosone.org/home.action |
Citation | PLoS One, 2012, v. 7 n. 8, article no. e43087 How to Cite? |
Abstract | INTRODUCTION: There is no data on the relationship between hepatitis B surface antigen (HBsAg) levels and liver fibrosis in hepatitis B e antigen (HBeAg)-positive patients with chronic hepatitis B (CHB). METHODS: Serum HBsAg and HBV DNA levels in HBeAg-positive CHB patients with liver biopsies were analyzed. The upper limit of normal (ULN) of alanine aminotransferase (ALT) was 30 and 19 U/L for men and women respectively. Histologic assessment was based on Ishak fibrosis staging for fibrosis and Knodell histologic activity index (HAI) for necroinflammation. RESULTS: 140 patients (65% male, median age 32.7 years) were recruited. 56 (40%) had ALT =2xULN. 72 (51.4%) and 42 (30%) had fibrosis score = 1 and necroinflammation grading = 4 respectively. Patients with fibrosis score = 1, when compared to patients with fibrosis score >1, had significantly higher median HBsAg levels (50,320 and 7,820 IU/mL respectively, p<0.001). Among patients with ALT =2xULN, serum HBsAg levels achieved an area under receiver operating characteristic curve of 0.869 in predicting fibrosis score = 1. HBsAg levels did not accurately predict necroinflammation score. HBsAg >/= 25,000 IU/mL was independently associated with fibrosis score = 1 (p=0.025, odds ratio 9.042).Using this cut-off HBsAg level in patients with ALT =2xULN, positive and negative predictive values for predicting fibrosis score = 1 were 92.7% and 60.0% respectively. HBV DNA levels had no association with liver histology. CONCLUSION: Among HBeAg-positive patients with ALT =2xULN, high serum HBsAg levels can accurately predict fibrosis score = 1, and could potentially influence decisions concerning treatment commencement and reduce the need for liver biopsy. |
Persistent Identifier | http://hdl.handle.net/10722/164323 |
ISSN | 2023 Impact Factor: 2.9 2023 SCImago Journal Rankings: 0.839 |
PubMed Central ID | |
ISI Accession Number ID | |
References |
DC Field | Value | Language |
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dc.contributor.author | Seto, WK | en_HK |
dc.contributor.author | Wong, DKH | en_HK |
dc.contributor.author | Fung, J | en_HK |
dc.contributor.author | Ip, PPC | en_HK |
dc.contributor.author | Yuen, JCH | en_HK |
dc.contributor.author | Hung, IFN | en_HK |
dc.contributor.author | Lai, CL | en_HK |
dc.contributor.author | Yuen, MF | en_HK |
dc.date.accessioned | 2012-09-20T07:57:58Z | - |
dc.date.available | 2012-09-20T07:57:58Z | - |
dc.date.issued | 2012 | en_HK |
dc.identifier.citation | PLoS One, 2012, v. 7 n. 8, article no. e43087 | en_HK |
dc.identifier.issn | 1932-6203 | en_HK |
dc.identifier.uri | http://hdl.handle.net/10722/164323 | - |
dc.description.abstract | INTRODUCTION: There is no data on the relationship between hepatitis B surface antigen (HBsAg) levels and liver fibrosis in hepatitis B e antigen (HBeAg)-positive patients with chronic hepatitis B (CHB). METHODS: Serum HBsAg and HBV DNA levels in HBeAg-positive CHB patients with liver biopsies were analyzed. The upper limit of normal (ULN) of alanine aminotransferase (ALT) was 30 and 19 U/L for men and women respectively. Histologic assessment was based on Ishak fibrosis staging for fibrosis and Knodell histologic activity index (HAI) for necroinflammation. RESULTS: 140 patients (65% male, median age 32.7 years) were recruited. 56 (40%) had ALT </=2xULN. 72 (51.4%) and 42 (30%) had fibrosis score </= 1 and necroinflammation grading </= 4 respectively. Patients with fibrosis score </= 1, when compared to patients with fibrosis score >1, had significantly higher median HBsAg levels (50,320 and 7,820 IU/mL respectively, p<0.001). Among patients with ALT </=2xULN, serum HBsAg levels achieved an area under receiver operating characteristic curve of 0.869 in predicting fibrosis score </= 1. HBsAg levels did not accurately predict necroinflammation score. HBsAg >/= 25,000 IU/mL was independently associated with fibrosis score </= 1 (p=0.025, odds ratio 9.042).Using this cut-off HBsAg level in patients with ALT </=2xULN, positive and negative predictive values for predicting fibrosis score </= 1 were 92.7% and 60.0% respectively. HBV DNA levels had no association with liver histology. CONCLUSION: Among HBeAg-positive patients with ALT </=2xULN, high serum HBsAg levels can accurately predict fibrosis score </= 1, and could potentially influence decisions concerning treatment commencement and reduce the need for liver biopsy. | en_HK |
dc.language | eng | en_US |
dc.publisher | Public Library of Science. The Journal's web site is located at http://www.plosone.org/home.action | en_HK |
dc.relation.ispartof | PLoS ONE | en_HK |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | Accuracy | - |
dc.subject | Alanine aminotransferase blood level | - |
dc.subject | Diagnostic test accuracy study | - |
dc.subject | Disease severity | - |
dc.subject | Hepatitis B | - |
dc.title | High hepatitis B surface antigen levels predict insignificant fibrosis in hepatitis B e antigen positive chronic hepatitis B | en_HK |
dc.type | Article | en_HK |
dc.identifier.email | Seto, WK: wkseto@gmail.com | en_HK |
dc.identifier.email | Wong, DKH: danywong@hku.hk | en_HK |
dc.identifier.email | Fung, J: jfung@hkucc.hku.hk | en_HK |
dc.identifier.email | Ip, PPC: philipip@hkucc.hku.hk | en_HK |
dc.identifier.email | Yuen, JCH: jchyuen@hkucc.hku.hk | en_HK |
dc.identifier.email | Hung, IFN: ivanhung@hkucc.hku.hk | - |
dc.identifier.email | Lai, CL: hrmelcl@hku.hk | - |
dc.identifier.email | Yuen, MF: mfyuen@hku.hk | - |
dc.identifier.authority | Seto, WK=rp01659 | en_HK |
dc.identifier.authority | Wong, DH=rp00492 | en_HK |
dc.identifier.authority | Fung, J=rp00518 | en_HK |
dc.identifier.authority | Lai, CL=rp00314 | en_HK |
dc.identifier.authority | Lai, CL=rp00314 | en_HK |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.1371/journal.pone.0043087 | en_HK |
dc.identifier.pmid | 22916211 | - |
dc.identifier.pmcid | PMC3423440 | - |
dc.identifier.scopus | eid_2-s2.0-84865176357 | en_HK |
dc.identifier.hkuros | 208878 | en_US |
dc.relation.references | http://www.scopus.com/mlt/select.url?eid=2-s2.0-84865176357&selection=ref&src=s&origin=recordpage | en_HK |
dc.identifier.volume | 7 | en_HK |
dc.identifier.issue | 8, article no. e43087 | en_HK |
dc.identifier.isi | WOS:000307733800046 | - |
dc.publisher.place | United States | en_HK |
dc.identifier.scopusauthorid | Yuen, MF=7102031955 | en_HK |
dc.identifier.scopusauthorid | Lai, CL=7403086396 | en_HK |
dc.identifier.scopusauthorid | Hung, IN=55193217000 | en_HK |
dc.identifier.scopusauthorid | Yuen, JH=7102620480 | en_HK |
dc.identifier.scopusauthorid | Ip, PPC=54958906200 | en_HK |
dc.identifier.scopusauthorid | Fung, J=23091109300 | en_HK |
dc.identifier.scopusauthorid | Wong, DH=7401535819 | en_HK |
dc.identifier.scopusauthorid | Seto, WK=23390675900 | en_HK |
dc.identifier.issnl | 1932-6203 | - |