Naslov
Hepatitis B DNA and not quantitative surface antigen as a predictor of severity of liver disease in untreated genotype A e-antigen negative disease

Autori
Gonsalkorala, E ; Sadler, MD ; Bruce, M ; Horner, M ; Mrzljak, Anna ; Verma, S ; Carey, I ; Agarwal K

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Journal of Hepatology / Elsevier - : European Association for the Study of the Liver, 2016

Skup
51st annual meeting of the European Association for the Study of the Live

Mjesto i datum
Barcelona, Španjolska, 2016

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
hepatitis B, DNA, quantitative surface antigen, genotype A

Sažetak
Background and Aims: Chronic hepatitis B (HBV) is a heterogenous phenotypic disease with genotypic variation in disease severity, outcome and response to treatment. Genotypes C and D have been associated with more severe disease and genotypes B and C associated with higher risk of hepatocellular carcinoma. Quantitative surface antigen level measurement (qHBsAg) is now routinely used in clinical practice. Aim: In this cross-sectional study, we explored association between qHBsAg, ethnicity, hepatic function and fibrosis in genotype A HBV e- antigen negative (eAg-neg) patients. Methods: We retrospectively reviewed patients at King’s College Hospital with untreated HBV genotype A eAg-neg disease and qHBsAg. Patients with liver fibrosis assessment (APRI score, King’s score, FibroScan or liver biopsy) around the time of qHBsAg testing were included. Statistical analysis was performed using SPSS v21. Results: Since 2004, 132 (median age 36.6yrs IQR 14.3 55% female) genotype A eAg-neg patients had qHBsAg levels and liver fibrosis assessment. Majority (65%, 86/132) were African/Caribbean. Liver fibrosis was mild, moderate and severe in 97 (73%), 26 (20%) and 9 (7%) patients respectively. Age was similar across the groups (p = 0.887). HBV DNA (p = 0.001) and ratio of qHBsAg/HBV DNA (p = 0.001) were significantly different between the 3 groups, however qHBsAg was not (p = 0.177). qHBsAg/HBV DNA ratio <1.0 was a marker of moderate/severe fibrosis (p =0.000, OR 0.212 95% CI 0.48–0.93). Ratio cut off of 1.0 gave an AUROC of 0.7 (95%CI 0.59– 0.81). No difference in fibrosis was seen between ethnicities (p = 0.352). There was a difference in quantitative surface antigen levels between ethnicities (p = 0.007), with levels being significantly higher in Caucasians (p = 0.005). Conclusions: Genotype A HBV eAg-neg patients had low level of fibrosis, in contrast to genotype E patients at the same centre (EASL 2014). Although qHBsAg levels did not differ between fibrosis groups, qHBsAg/HBV DNA ratio <1.0 predicted patients with moderate/severe fibrosis. Caucasian patients had significantly higher qHBsAg without an increased fibrosis risk or low qHBsAg/HBV DNA ratio, suggesting true hepatitis B e-antigen seroconversion with low viral load. In this cohort qHBsAg/HBV DNA provided insight into disease trajectory and fibrosis.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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