Serum hepatitis B surface antigen quantification as a useful assessment for significant fibrosis in hepatitis B e antigen-positive hepatitis B virus carriers
Background and Aims The role of serum quantitative hepatitis B surface antigen (qHBsAg) in identifying hepatitis B virus (HBV) carriers with significant fibrosis is unknown. This study aims to evaluate the diagnostic value of qHBsAg for hepatic fibrosis in hepatitis B e antigen (HBeAg)‐positive HBV...
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| Veröffentlicht in: | Journal of gastroenterology and hepatology 2013-11, Vol.28 (11), p.1746-1755 |
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| container_title | Journal of gastroenterology and hepatology |
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| creator | Xun, Yun-hao Zang, Guo-qing Guo, Jian-chun Yu, Xiu-li Liu, Hong Xiang, Jing Liu, Jing Shi, Jun-ping |
| description | Background and Aims
The role of serum quantitative hepatitis B surface antigen (qHBsAg) in identifying hepatitis B virus (HBV) carriers with significant fibrosis is unknown. This study aims to evaluate the diagnostic value of qHBsAg for hepatic fibrosis in hepatitis B e antigen (HBeAg)‐positive HBV carriers.
Methods
Consecutive biopsy‐proven HBeAg‐positive HBV carriers were prospectively recruited in our center from 2009 to 2011 and were randomly divided into training and validation set. Area under receiver‐operator curve (AUC) was used to determine the diagnostic accuracy of simple tests for significant fibrosis (Scheuer stage, F ≥ 2).
Results
Overall, a total of 197 eligible patients (median age 31 years; 149 males) were enrolled. The median qHBsAg was 4.20 (log10 IU/mL). Significant fibrosis was confirmed in 112 (56.9%) patients. By logistical regression analysis, qHBsAg and γ‐glutamyl transpeptidase were identified as predictors for significant fibrosis in training set (n = 124). Thus, qHBsAg index and γ‐glutamyl transpeptidase to qHBsAg ratio (GqHBsR) were selected for the subsequent analysis. In the training set, an AUC of 0.762, 0.826, 0.749, and 0.771 was observed for qHBsAg index, GqHBsR, FIB‐4, and aspartate aminotransferase to platelet ratio index, respectively (all P |
| doi_str_mv | 10.1111/jgh.12304 |
| format | Article |
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The role of serum quantitative hepatitis B surface antigen (qHBsAg) in identifying hepatitis B virus (HBV) carriers with significant fibrosis is unknown. This study aims to evaluate the diagnostic value of qHBsAg for hepatic fibrosis in hepatitis B e antigen (HBeAg)‐positive HBV carriers.
Methods
Consecutive biopsy‐proven HBeAg‐positive HBV carriers were prospectively recruited in our center from 2009 to 2011 and were randomly divided into training and validation set. Area under receiver‐operator curve (AUC) was used to determine the diagnostic accuracy of simple tests for significant fibrosis (Scheuer stage, F ≥ 2).
Results
Overall, a total of 197 eligible patients (median age 31 years; 149 males) were enrolled. The median qHBsAg was 4.20 (log10 IU/mL). Significant fibrosis was confirmed in 112 (56.9%) patients. By logistical regression analysis, qHBsAg and γ‐glutamyl transpeptidase were identified as predictors for significant fibrosis in training set (n = 124). Thus, qHBsAg index and γ‐glutamyl transpeptidase to qHBsAg ratio (GqHBsR) were selected for the subsequent analysis. In the training set, an AUC of 0.762, 0.826, 0.749, and 0.771 was observed for qHBsAg index, GqHBsR, FIB‐4, and aspartate aminotransferase to platelet ratio index, respectively (all P < 0.05). GqHBsR yielded a higher AUC than aspartate aminotransferase to platelet ratio index and FIB‐4 (both P < 0.05). Using the optimal cut‐off of 7.78, GqHBsR showed a sensitivity of 78.9% and a specificity of 73.6%. About 80% of liver biopsy could be avoided in the entire cohort.
Conclusions
Serum qHBsAg‐based simple tests, especially GqHBsR, can accurately and specifically identify significant fibrosis in treatment‐naïve HBeAg‐positive HBV carriers.</description><identifier>ISSN: 0815-9319</identifier><identifier>EISSN: 1440-1746</identifier><identifier>DOI: 10.1111/jgh.12304</identifier><identifier>PMID: 23800140</identifier><language>eng</language><publisher>Australia: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Adult ; Age ; Biomarkers - blood ; Carrier State ; chronic HBV carriers ; Female ; gamma-Glutamyltransferase - blood ; HBeAg positive ; Hepatitis B - complications ; Hepatitis B - diagnosis ; Hepatitis B - virology ; Hepatitis B e Antigens - blood ; Hepatitis B e Antigens - immunology ; Hepatitis B Surface Antigens - blood ; Hepatitis B virus ; Hepatitis B virus - immunology ; Humans ; Liver Cirrhosis - diagnosis ; Liver Cirrhosis - etiology ; Liver Cirrhosis - virology ; Male ; Middle Aged ; non-invasive diagnosis ; Prospective Studies ; quantitative HBsAg ; Random Allocation ; Regression Analysis ; ROC Curve ; Sensitivity and Specificity ; significant fibrosis ; Young Adult</subject><ispartof>Journal of gastroenterology and hepatology, 2013-11, Vol.28 (11), p.1746-1755</ispartof><rights>2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd</rights><rights>2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3964-b4078efe9e19a24ebc8aca40dc4656d047fdd39619e866e779efc72b1c17172b3</citedby><cites>FETCH-LOGICAL-c3964-b4078efe9e19a24ebc8aca40dc4656d047fdd39619e866e779efc72b1c17172b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjgh.12304$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjgh.12304$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,778,782,1414,27907,27908,45557,45558</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23800140$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Xun, Yun-hao</creatorcontrib><creatorcontrib>Zang, Guo-qing</creatorcontrib><creatorcontrib>Guo, Jian-chun</creatorcontrib><creatorcontrib>Yu, Xiu-li</creatorcontrib><creatorcontrib>Liu, Hong</creatorcontrib><creatorcontrib>Xiang, Jing</creatorcontrib><creatorcontrib>Liu, Jing</creatorcontrib><creatorcontrib>Shi, Jun-ping</creatorcontrib><title>Serum hepatitis B surface antigen quantification as a useful assessment for significant fibrosis in hepatitis B e antigen-positive hepatitis B virus carriers</title><title>Journal of gastroenterology and hepatology</title><addtitle>J Gastroenterol Hepatol</addtitle><description>Background and Aims
The role of serum quantitative hepatitis B surface antigen (qHBsAg) in identifying hepatitis B virus (HBV) carriers with significant fibrosis is unknown. This study aims to evaluate the diagnostic value of qHBsAg for hepatic fibrosis in hepatitis B e antigen (HBeAg)‐positive HBV carriers.
Methods
Consecutive biopsy‐proven HBeAg‐positive HBV carriers were prospectively recruited in our center from 2009 to 2011 and were randomly divided into training and validation set. Area under receiver‐operator curve (AUC) was used to determine the diagnostic accuracy of simple tests for significant fibrosis (Scheuer stage, F ≥ 2).
Results
Overall, a total of 197 eligible patients (median age 31 years; 149 males) were enrolled. The median qHBsAg was 4.20 (log10 IU/mL). Significant fibrosis was confirmed in 112 (56.9%) patients. By logistical regression analysis, qHBsAg and γ‐glutamyl transpeptidase were identified as predictors for significant fibrosis in training set (n = 124). Thus, qHBsAg index and γ‐glutamyl transpeptidase to qHBsAg ratio (GqHBsR) were selected for the subsequent analysis. In the training set, an AUC of 0.762, 0.826, 0.749, and 0.771 was observed for qHBsAg index, GqHBsR, FIB‐4, and aspartate aminotransferase to platelet ratio index, respectively (all P < 0.05). GqHBsR yielded a higher AUC than aspartate aminotransferase to platelet ratio index and FIB‐4 (both P < 0.05). Using the optimal cut‐off of 7.78, GqHBsR showed a sensitivity of 78.9% and a specificity of 73.6%. About 80% of liver biopsy could be avoided in the entire cohort.
Conclusions
Serum qHBsAg‐based simple tests, especially GqHBsR, can accurately and specifically identify significant fibrosis in treatment‐naïve HBeAg‐positive HBV carriers.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>Biomarkers - blood</subject><subject>Carrier State</subject><subject>chronic HBV carriers</subject><subject>Female</subject><subject>gamma-Glutamyltransferase - blood</subject><subject>HBeAg positive</subject><subject>Hepatitis B - complications</subject><subject>Hepatitis B - diagnosis</subject><subject>Hepatitis B - virology</subject><subject>Hepatitis B e Antigens - blood</subject><subject>Hepatitis B e Antigens - immunology</subject><subject>Hepatitis B Surface Antigens - blood</subject><subject>Hepatitis B virus</subject><subject>Hepatitis B virus - immunology</subject><subject>Humans</subject><subject>Liver Cirrhosis - diagnosis</subject><subject>Liver Cirrhosis - etiology</subject><subject>Liver Cirrhosis - virology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>non-invasive diagnosis</subject><subject>Prospective Studies</subject><subject>quantitative HBsAg</subject><subject>Random Allocation</subject><subject>Regression Analysis</subject><subject>ROC Curve</subject><subject>Sensitivity and Specificity</subject><subject>significant fibrosis</subject><subject>Young Adult</subject><issn>0815-9319</issn><issn>1440-1746</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkd9OFDEUhxsjkQW88AVML_VioN3ptNNLJbhICCYK8bLpdE6X4vxZeqYoD8O72mVhEy5M7M05zfnOl7Q_Qt5xdsjzObpZXh_yecnEKzLjQrCCKyFfkxmreVXokutdsod4wxgTTFVvyO68rBnjgs3Iww-IqafXsLJTmALSzxRT9NYBtcMUljDQ27TufHCZGAdqkVqaEHzqco-A2MMwUT9GimE5PILre2jiiFkYhhf2rbdY5fEU7uDF-C7EhNTZGANEPCA73nYIb5_qPrn6cnJ5fFqcf1t8Pf50XrhSS1E0-Vk1eNDAtZ0LaFxtnRWsdUJWsmVC-bbNJNdQSwlKafBOzRvuuOK5lvvkw8a7iuNtApxMH9BB19kBxoSGCykqzrWS_4EKUVdSszqjHzeoyz-BEbxZxdDbeG84M-vgTA7OPAaX2fdP2tT00G7J56QycLQBfocO7v9tMmeL02dlsdkIOMGf7YaNv4xUparMz4uFOZNldVnr2nwv_wL7orQJ</recordid><startdate>201311</startdate><enddate>201311</enddate><creator>Xun, Yun-hao</creator><creator>Zang, Guo-qing</creator><creator>Guo, Jian-chun</creator><creator>Yu, Xiu-li</creator><creator>Liu, Hong</creator><creator>Xiang, Jing</creator><creator>Liu, Jing</creator><creator>Shi, Jun-ping</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7U9</scope><scope>H94</scope></search><sort><creationdate>201311</creationdate><title>Serum hepatitis B surface antigen quantification as a useful assessment for significant fibrosis in hepatitis B e antigen-positive hepatitis B virus carriers</title><author>Xun, Yun-hao ; Zang, Guo-qing ; Guo, Jian-chun ; Yu, Xiu-li ; Liu, Hong ; Xiang, Jing ; Liu, Jing ; Shi, Jun-ping</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3964-b4078efe9e19a24ebc8aca40dc4656d047fdd39619e866e779efc72b1c17172b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>Biomarkers - blood</topic><topic>Carrier State</topic><topic>chronic HBV carriers</topic><topic>Female</topic><topic>gamma-Glutamyltransferase - blood</topic><topic>HBeAg positive</topic><topic>Hepatitis B - complications</topic><topic>Hepatitis B - diagnosis</topic><topic>Hepatitis B - virology</topic><topic>Hepatitis B e Antigens - blood</topic><topic>Hepatitis B e Antigens - immunology</topic><topic>Hepatitis B Surface Antigens - blood</topic><topic>Hepatitis B virus</topic><topic>Hepatitis B virus - immunology</topic><topic>Humans</topic><topic>Liver Cirrhosis - diagnosis</topic><topic>Liver Cirrhosis - etiology</topic><topic>Liver Cirrhosis - virology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>non-invasive diagnosis</topic><topic>Prospective Studies</topic><topic>quantitative HBsAg</topic><topic>Random Allocation</topic><topic>Regression Analysis</topic><topic>ROC Curve</topic><topic>Sensitivity and Specificity</topic><topic>significant fibrosis</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Xun, Yun-hao</creatorcontrib><creatorcontrib>Zang, Guo-qing</creatorcontrib><creatorcontrib>Guo, Jian-chun</creatorcontrib><creatorcontrib>Yu, Xiu-li</creatorcontrib><creatorcontrib>Liu, Hong</creatorcontrib><creatorcontrib>Xiang, Jing</creatorcontrib><creatorcontrib>Liu, Jing</creatorcontrib><creatorcontrib>Shi, Jun-ping</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Journal of gastroenterology and hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Xun, Yun-hao</au><au>Zang, Guo-qing</au><au>Guo, Jian-chun</au><au>Yu, Xiu-li</au><au>Liu, Hong</au><au>Xiang, Jing</au><au>Liu, Jing</au><au>Shi, Jun-ping</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Serum hepatitis B surface antigen quantification as a useful assessment for significant fibrosis in hepatitis B e antigen-positive hepatitis B virus carriers</atitle><jtitle>Journal of gastroenterology and hepatology</jtitle><addtitle>J Gastroenterol Hepatol</addtitle><date>2013-11</date><risdate>2013</risdate><volume>28</volume><issue>11</issue><spage>1746</spage><epage>1755</epage><pages>1746-1755</pages><issn>0815-9319</issn><eissn>1440-1746</eissn><abstract>Background and Aims
The role of serum quantitative hepatitis B surface antigen (qHBsAg) in identifying hepatitis B virus (HBV) carriers with significant fibrosis is unknown. This study aims to evaluate the diagnostic value of qHBsAg for hepatic fibrosis in hepatitis B e antigen (HBeAg)‐positive HBV carriers.
Methods
Consecutive biopsy‐proven HBeAg‐positive HBV carriers were prospectively recruited in our center from 2009 to 2011 and were randomly divided into training and validation set. Area under receiver‐operator curve (AUC) was used to determine the diagnostic accuracy of simple tests for significant fibrosis (Scheuer stage, F ≥ 2).
Results
Overall, a total of 197 eligible patients (median age 31 years; 149 males) were enrolled. The median qHBsAg was 4.20 (log10 IU/mL). Significant fibrosis was confirmed in 112 (56.9%) patients. By logistical regression analysis, qHBsAg and γ‐glutamyl transpeptidase were identified as predictors for significant fibrosis in training set (n = 124). Thus, qHBsAg index and γ‐glutamyl transpeptidase to qHBsAg ratio (GqHBsR) were selected for the subsequent analysis. In the training set, an AUC of 0.762, 0.826, 0.749, and 0.771 was observed for qHBsAg index, GqHBsR, FIB‐4, and aspartate aminotransferase to platelet ratio index, respectively (all P < 0.05). GqHBsR yielded a higher AUC than aspartate aminotransferase to platelet ratio index and FIB‐4 (both P < 0.05). Using the optimal cut‐off of 7.78, GqHBsR showed a sensitivity of 78.9% and a specificity of 73.6%. About 80% of liver biopsy could be avoided in the entire cohort.
Conclusions
Serum qHBsAg‐based simple tests, especially GqHBsR, can accurately and specifically identify significant fibrosis in treatment‐naïve HBeAg‐positive HBV carriers.</abstract><cop>Australia</cop><pub>Blackwell Publishing Ltd</pub><pmid>23800140</pmid><doi>10.1111/jgh.12304</doi><tpages>10</tpages></addata></record> |
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| subjects | Adolescent Adult Age Biomarkers - blood Carrier State chronic HBV carriers Female gamma-Glutamyltransferase - blood HBeAg positive Hepatitis B - complications Hepatitis B - diagnosis Hepatitis B - virology Hepatitis B e Antigens - blood Hepatitis B e Antigens - immunology Hepatitis B Surface Antigens - blood Hepatitis B virus Hepatitis B virus - immunology Humans Liver Cirrhosis - diagnosis Liver Cirrhosis - etiology Liver Cirrhosis - virology Male Middle Aged non-invasive diagnosis Prospective Studies quantitative HBsAg Random Allocation Regression Analysis ROC Curve Sensitivity and Specificity significant fibrosis Young Adult |
| title | Serum hepatitis B surface antigen quantification as a useful assessment for significant fibrosis in hepatitis B e antigen-positive hepatitis B virus carriers |
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