Serum hepatitis B surface antigen levels in the natural history of chronic hepatitis B infection

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2011.04888.x/abstract

Serum hepatitis B surface antigen levels in the natural history of chronic

hepatitis B infection

J. W. Jang1, S. H. Yoo1, J. H. Kwon1, C. R. You1, S. Lee2, J. H. Lee2, K. W.

Chung1

Article first published online: 18 OCT 2011

DOI: 10.1111/j.1365-2036.2011.04888.x

© 2011 Blackwell Publishing Ltd

Issue

Alimentary Pharmacology & Therapeutics

Early View (Online Version of Record published before inclusion in an issue)

Summary

Background  The production of hepatitis B surface antigen (HBsAg) may evolve

during long-lasting virus-host interactions in chronic hepatitis B (CHB). The

impact of age on HBsAg production remains unclear.

Aim  To determine the age-specific distribution patterns of HBsAg and related

factors during the natural course of CHB infection.

Methods  Seven hundred and sixty-eight untreated HBsAg carriers were enrolled

in the study. The parameters and distribution patterns of HBsAg were evaluated

in relation to age and immune phases.

Results  The HBsAg levels were significantly lower in the HBeAg-negative

stage, with the lowest levels in inactive carriers. The HBsAg tended to decrease

from hepatitis to cirrhosis and to hepatocellular carcinoma, and from

Child–Pugh class A to B and to C. Age and HBV DNA were independently

associated with HBsAg levels. In HBeAg-positive patients, the HBsAg levels were

distributed in a triphasic-like decline pattern by 2 logs across age strata. For

HBeAg-negative patients, the titres in inactive carriers exhibited a 2-log

reduction, but remained unchanged over age strata in patients with

HBeAg-negative hepatitis. The ratios of HBsAg/HBV-DNA were highest, but steadily

decreased with age in inactive carriers, whereas the levels remained largely

unchanged over the entire age strata in patients with HBeAg-negative hepatitis.

Conclusions  Age and HBV DNA levels are independent parameters of HBsAg

levels. During the natural course of CHB infection, HBsAg levels decrease with

age and disease progression, but the patterns are significantly different

between the immune phases of CHB. This information may contribute to our

understanding of the immunopathogenesis of chronic hepatitis B and management

involving HBsAg quantification.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2011.04888.x/abstract

Serum hepatitis B surface antigen levels in the natural history of chronic

hepatitis B infection

J. W. Jang1, S. H. Yoo1, J. H. Kwon1, C. R. You1, S. Lee2, J. H. Lee2, K. W.

Chung1

Article first published online: 18 OCT 2011

DOI: 10.1111/j.1365-2036.2011.04888.x

© 2011 Blackwell Publishing Ltd

Issue

Alimentary Pharmacology & Therapeutics

Early View (Online Version of Record published before inclusion in an issue)

Summary

Background  The production of hepatitis B surface antigen (HBsAg) may evolve

during long-lasting virus-host interactions in chronic hepatitis B (CHB). The

impact of age on HBsAg production remains unclear.

Aim  To determine the age-specific distribution patterns of HBsAg and related

factors during the natural course of CHB infection.

Methods  Seven hundred and sixty-eight untreated HBsAg carriers were enrolled

in the study. The parameters and distribution patterns of HBsAg were evaluated

in relation to age and immune phases.

Results  The HBsAg levels were significantly lower in the HBeAg-negative

stage, with the lowest levels in inactive carriers. The HBsAg tended to decrease

from hepatitis to cirrhosis and to hepatocellular carcinoma, and from

Child–Pugh class A to B and to C. Age and HBV DNA were independently

associated with HBsAg levels. In HBeAg-positive patients, the HBsAg levels were

distributed in a triphasic-like decline pattern by 2 logs across age strata. For

HBeAg-negative patients, the titres in inactive carriers exhibited a 2-log

reduction, but remained unchanged over age strata in patients with

HBeAg-negative hepatitis. The ratios of HBsAg/HBV-DNA were highest, but steadily

decreased with age in inactive carriers, whereas the levels remained largely

unchanged over the entire age strata in patients with HBeAg-negative hepatitis.

Conclusions  Age and HBV DNA levels are independent parameters of HBsAg

levels. During the natural course of CHB infection, HBsAg levels decrease with

age and disease progression, but the patterns are significantly different

between the immune phases of CHB. This information may contribute to our

understanding of the immunopathogenesis of chronic hepatitis B and management

involving HBsAg quantification.