Role of hepatitis B surface antigen (HBsAg) in identifying true inactive HBsAg carriers infected with genotype C hepatitis B virus

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Abstract

BACKGROUND:: Inactive and active phases of hepatitis B e antigen-negative chronic hepatitis B virus (HBV) infection are diagnosed by serum HBV DNA levels, with cutoff at 2000 IU/mL. However, it is difficult to distinguish inactive carriers at a single time point because HBV DNA levels can transiently decrease to <2000 IU/mL even in noninactive carriers. GOALS:: We aimed to establish the role of serum hepatitis B surface antigen (HBsAg) in identifying "true inactive carriers" among treatment-naive genotype C HBV-infected patients with low viremia. STUDY:: A total of 133 hepatitis B e antigen-negative carriers with serum HBV DNA levels of <2000 IU/mL and normal alanine aminotransferase levels were enrolled and followed up for >12 months. RESULTS:: Forty patients (30.1%) were classified as noninactive carriers (HBV DNA ≥2000 IU/mL and/or alanine aminotransferase >40 IU/L) during 12 months from enrollment. No baseline serum HBV DNA levels could identify true inactive carriers with 100% specificity, whereas baseline serum HBsAg levels (50 IU/mL) identified true inactive carriers with 100% specificity and 29% detection rate. Detection rate increased when different cutoff levels were applied to different age groups according to median age (46 y). It was comparable in both younger and older groups (37.2% vs. 38%) even when HBsAg cutoff level was increased in the former (400 vs. 50 IU/mL). Furthermore, none reversed to noninactive phase during long-term follow-up when these cutoff levels were applied. CONCLUSIONS:: Baseline serum HBsAg levels at a single time point can identify persistently true inactive carriers, with different cutoff levels according to age.

Original languageEnglish
Pages (from-to)166-171
Number of pages6
JournalJournal of Clinical Gastroenterology
Volume48
Issue number2
DOIs
Publication statusPublished - 2014 Feb 1

Fingerprint

Hepatitis B Surface Antigens
Hepatitis B virus
Genotype
DNA
Serum
Hepatitis B e Antigens
Chronic Hepatitis B
Virus Diseases
Alanine Transaminase
Age Groups

Keywords

  • HBeAg-negative chronic hepatitis B
  • inactive carriers
  • serum HBsAg levels
  • serum HBV DNA levels

ASJC Scopus subject areas

  • Gastroenterology

Cite this

@article{21f115d99913420796bcc0cebd9564b0,
title = "Role of hepatitis B surface antigen (HBsAg) in identifying true inactive HBsAg carriers infected with genotype C hepatitis B virus",
abstract = "BACKGROUND:: Inactive and active phases of hepatitis B e antigen-negative chronic hepatitis B virus (HBV) infection are diagnosed by serum HBV DNA levels, with cutoff at 2000 IU/mL. However, it is difficult to distinguish inactive carriers at a single time point because HBV DNA levels can transiently decrease to <2000 IU/mL even in noninactive carriers. GOALS:: We aimed to establish the role of serum hepatitis B surface antigen (HBsAg) in identifying {"}true inactive carriers{"} among treatment-naive genotype C HBV-infected patients with low viremia. STUDY:: A total of 133 hepatitis B e antigen-negative carriers with serum HBV DNA levels of <2000 IU/mL and normal alanine aminotransferase levels were enrolled and followed up for >12 months. RESULTS:: Forty patients (30.1{\%}) were classified as noninactive carriers (HBV DNA ≥2000 IU/mL and/or alanine aminotransferase >40 IU/L) during 12 months from enrollment. No baseline serum HBV DNA levels could identify true inactive carriers with 100{\%} specificity, whereas baseline serum HBsAg levels (50 IU/mL) identified true inactive carriers with 100{\%} specificity and 29{\%} detection rate. Detection rate increased when different cutoff levels were applied to different age groups according to median age (46 y). It was comparable in both younger and older groups (37.2{\%} vs. 38{\%}) even when HBsAg cutoff level was increased in the former (400 vs. 50 IU/mL). Furthermore, none reversed to noninactive phase during long-term follow-up when these cutoff levels were applied. CONCLUSIONS:: Baseline serum HBsAg levels at a single time point can identify persistently true inactive carriers, with different cutoff levels according to age.",
keywords = "HBeAg-negative chronic hepatitis B, inactive carriers, serum HBsAg levels, serum HBV DNA levels",
author = "Yim, {Sun Young} and Soon-Ho Um and Jung, {Jin Young} and Seo, {Yeon Seok} and Yim, {Hyung Joon} and Ryu, {Ho Sang} and Hoon-Jai Chun and Jeen, {Yoon Tae} and Kim, {Chang Duck} and Bora Keum and Lee, {Hong Sik}",
year = "2014",
month = "2",
day = "1",
doi = "10.1097/MCG.0b013e3182a4711d",
language = "English",
volume = "48",
pages = "166--171",
journal = "Journal of Clinical Gastroenterology",
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publisher = "Lippincott Williams and Wilkins",
number = "2",

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TY - JOUR

T1 - Role of hepatitis B surface antigen (HBsAg) in identifying true inactive HBsAg carriers infected with genotype C hepatitis B virus

AU - Yim, Sun Young

AU - Um, Soon-Ho

AU - Jung, Jin Young

AU - Seo, Yeon Seok

AU - Yim, Hyung Joon

AU - Ryu, Ho Sang

AU - Chun, Hoon-Jai

AU - Jeen, Yoon Tae

AU - Kim, Chang Duck

AU - Keum, Bora

AU - Lee, Hong Sik

PY - 2014/2/1

Y1 - 2014/2/1

N2 - BACKGROUND:: Inactive and active phases of hepatitis B e antigen-negative chronic hepatitis B virus (HBV) infection are diagnosed by serum HBV DNA levels, with cutoff at 2000 IU/mL. However, it is difficult to distinguish inactive carriers at a single time point because HBV DNA levels can transiently decrease to <2000 IU/mL even in noninactive carriers. GOALS:: We aimed to establish the role of serum hepatitis B surface antigen (HBsAg) in identifying "true inactive carriers" among treatment-naive genotype C HBV-infected patients with low viremia. STUDY:: A total of 133 hepatitis B e antigen-negative carriers with serum HBV DNA levels of <2000 IU/mL and normal alanine aminotransferase levels were enrolled and followed up for >12 months. RESULTS:: Forty patients (30.1%) were classified as noninactive carriers (HBV DNA ≥2000 IU/mL and/or alanine aminotransferase >40 IU/L) during 12 months from enrollment. No baseline serum HBV DNA levels could identify true inactive carriers with 100% specificity, whereas baseline serum HBsAg levels (50 IU/mL) identified true inactive carriers with 100% specificity and 29% detection rate. Detection rate increased when different cutoff levels were applied to different age groups according to median age (46 y). It was comparable in both younger and older groups (37.2% vs. 38%) even when HBsAg cutoff level was increased in the former (400 vs. 50 IU/mL). Furthermore, none reversed to noninactive phase during long-term follow-up when these cutoff levels were applied. CONCLUSIONS:: Baseline serum HBsAg levels at a single time point can identify persistently true inactive carriers, with different cutoff levels according to age.

AB - BACKGROUND:: Inactive and active phases of hepatitis B e antigen-negative chronic hepatitis B virus (HBV) infection are diagnosed by serum HBV DNA levels, with cutoff at 2000 IU/mL. However, it is difficult to distinguish inactive carriers at a single time point because HBV DNA levels can transiently decrease to <2000 IU/mL even in noninactive carriers. GOALS:: We aimed to establish the role of serum hepatitis B surface antigen (HBsAg) in identifying "true inactive carriers" among treatment-naive genotype C HBV-infected patients with low viremia. STUDY:: A total of 133 hepatitis B e antigen-negative carriers with serum HBV DNA levels of <2000 IU/mL and normal alanine aminotransferase levels were enrolled and followed up for >12 months. RESULTS:: Forty patients (30.1%) were classified as noninactive carriers (HBV DNA ≥2000 IU/mL and/or alanine aminotransferase >40 IU/L) during 12 months from enrollment. No baseline serum HBV DNA levels could identify true inactive carriers with 100% specificity, whereas baseline serum HBsAg levels (50 IU/mL) identified true inactive carriers with 100% specificity and 29% detection rate. Detection rate increased when different cutoff levels were applied to different age groups according to median age (46 y). It was comparable in both younger and older groups (37.2% vs. 38%) even when HBsAg cutoff level was increased in the former (400 vs. 50 IU/mL). Furthermore, none reversed to noninactive phase during long-term follow-up when these cutoff levels were applied. CONCLUSIONS:: Baseline serum HBsAg levels at a single time point can identify persistently true inactive carriers, with different cutoff levels according to age.

KW - HBeAg-negative chronic hepatitis B

KW - inactive carriers

KW - serum HBsAg levels

KW - serum HBV DNA levels

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U2 - 10.1097/MCG.0b013e3182a4711d

DO - 10.1097/MCG.0b013e3182a4711d

M3 - Article

VL - 48

SP - 166

EP - 171

JO - Journal of Clinical Gastroenterology

JF - Journal of Clinical Gastroenterology

SN - 0192-0790

IS - 2

ER -