Hepatitis B Surface Antigen Levels Can Be Used to Rule Out Cirrhosis in Hepatitis B e Antigen-Positive Chronic Hepatitis B: Results From the SONIC-B Study.

Abstract

BACKGROUND:

Serum hepatitis B surface antigen (HBsAg) levels correlate with the duration of chronic hepatitis B virus (HBV) infection and may predict the extent of hepatic fibrosis.

METHODS:

We analyzed data from the SONIC-B database, which contains data from 8 global randomized trials and 2 large hepatology centers. Relationship between HBsAg levels and presence of significant fibrosis (Ishak 3-4) or cirrhosis (Ishak 5-6) were explored, and clinically relevant cutoffs were identified to rule out cirrhosis.

RESULTS:

The dataset included 2779 patients: 1866 hepatitis B e antigen (HBeAg)-positive; 322 with cirrhosis. Among HBeAg-positive patients, lower HBsAg levels were associated with higher rates of significant fibrosis (odds ratio [OR], 0.419; P < .001) and cirrhosis (OR, 0.435; P < .001). No relationship was observed among HBeAg-negative patients. Among HBeAg-positive patients, genotype-specific HBsAg cutoffs had excellent negative predictive values (>97%) and low misclassification rates (≤7.1%) and may therefore have utility in ruling out cirrhosis. Diagnostic performance of the HBsAg cutoffs was comparable among patients in whom cirrhosis could not be ruled out with fibrosis 4 (FIB-4).

CONCLUSIONS:

Hepatitis B virus genotype-specific HBsAg cutoffs may have utility in ruling out presence of cirrhosis in HBeAg-positive patients with genotypes B, C, and D and can be an adjunct to FIB-4 to reduce the need for further testing.

• Authors: Milan J Sonneveld, Bettina E Hansen, Willem P Brouwer, Henry L-Y Chan, Teerha Piratvisuth, Ji-Dong Jia, Stefan Zeuzem, Rong-Nan Chien, Robert J de Knegt, Cynthia Wat, Vedran Pavlovic, Anuj Gaggar, Qing Xie, Maria Buti, Robert A de Man, Harry L A Janssen, SONIC-B Study Group
• Journal: The Journal of infectious diseases (J Infect Dis) Vol. 225 Issue 11 Pg. 1967-1973 (06 01 2022) ISSN: 1537-6613 [Electronic] United States
• PMID: 32318704 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.

Chemical References

• Hepatitis B e Antigens
• Hepatitis B Surface Antigens
• DNA, Viral

Topics

• Humans
• Hepatitis B e Antigens
• Hepatitis B, Chronic (complications)
• Hepatitis B Surface Antigens
• Liver Cirrhosis (diagnosis, complications)
• Hepatitis B virus (genetics)
• DNA, Viral