The clinical value of serum hepatic parenchyma cell volume-normalized hepatitis B surface antigen levels in hepatitis B e antigen -positive and -negative chronic hepatitis B patients

Lei Tan; Shi-Lei Xu; Zhi-Shuo Mo; Jian-Rong Liu; Wei-Qiang Gan; Jie-Huan Chen; Zhi-Liang Gao; Ze-Qian Wu

doi:10.21037/atm-21-3846

The clinical value of serum hepatic parenchyma cell volume-normalized hepatitis B surface antigen levels in hepatitis B e antigen -positive and -negative chronic hepatitis B patients

Ann Transl Med. 2021 Sep;9(18):1431. doi: 10.21037/atm-21-3846.

Authors

Lei Tan¹, Shi-Lei Xu², Zhi-Shuo Mo^{3

4}, Jian-Rong Liu⁵, Wei-Qiang Gan^{3

4}, Jie-Huan Chen⁶, Zhi-Liang Gao^{3

4}, Ze-Qian Wu^{3

4}

Affiliations

¹ Department of Medical Ultrasonic, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
² Department of General Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
³ Department of Infectious Diseases, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
⁴ Key Laboratory of Topical Disease Control, Sun Yat-sen University, Ministry of Education, Guangzhou, China.
⁵ Surgical and Transplant Intensive Care Unit, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
⁶ Department of Ultrasound, Binhaiwan Central Hospital of Dongguan, Dongguan, China.

Abstract

Background: While serum hepatitis B surface antigens (HBsAg) play an important role in the diagnosis and assessment of treatment results of hepatitis B virus (HBV) infections, it remains unclear whether HBsAg levels normalized to hepatic parenchymal cell volume (HPCV) is a superior indicator of disease state. This study compared the absolute and HPCV-normalized serum HBsAg levels in hepatitis B e antigen (HBeAg)-positive and HBeAg-negative patients with chronic hepatitis B (CHB).

Methods: Patients admitted to our institution with CHB were retrospectively included and categorized into the HBeAg-positive and HBeAg-negative groups. HPCV was calculated based on pathological examination of liver biopsy specimens and theory of sphere geometry. The difference between HBsAg levels and HBsAg normalized to HPCV, and also correlation between HBsAg levels and liver inflammation and fibrosis was analyzed.

Results: Absolute HBsAg levels (P=0.004), but not HPCV-normalized HBsAg levels (P=0.071) were significantly higher in HBeAg-positive patients compared to HBeAg-negative patients. In HBeAg-positive CHB patients, absolute HBsAg levels were positively correlated with liver inflammation grade (R=0.285, P=0.001) and hepatic fibrosis stage (R=0.351, P<0.001), as were HPCV-normalized HBsAg levels (R=0.640 and 0.742, both, P<0.001). However, in HBeAg-negative CHB patients, only HPCV-normalized HBsAg level were correlated with liver inflammation grade and hepatic fibrosis stage (R=0.640 and 0.785, both, P<0.001).

Conclusions: HPCV-normalized serum HBsAg levels, rather than absolute HBsAg levels, were positively correlated with liver inflammation grade and hepatic fibrosis stage in both HBeAg-positive and HBeAg-negative CHB patients. Thus, HPCV-normalized HBsAg levels may more accurately reflect the pathological progress of CHB patients compared to absolute HBsAg levels.

Keywords: Serum hepatitis B surface antigens level (serum HBsAg level); hepatic fibrosis stages; hepatic parenchyma cell volume (hepatic cell quantities); liver inflammation grades.