Re-recognizing serological change patterns and antiviral therapy opportunity of patients with acute hepatitis B through highly sensitive detection technology

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• 作者：Haixia Ma^a ; ^b ; ¹ ; Min Gao^b ; ¹ ; Jia Li^b ; ^{18622663700@163.com" class="auth_mail" title="E-mail the corresponding author} ; Li Zhou^b ; Jie Guo^b ; Junjuan Liu^b ; Xu Han^b ; Lu Zhai^b ; Ting Wu^a ; ^b
• 关键词：AHB ; Acute hepatitis B ; HBV ; Hepatitis B virus ; HBsAg ; Hepatitis B surface antigen ; PCR ; Polymerase chain reaction ; HBV-Ms ; Serological markers of HBV ; ECLIA ; Electrochemiluminescence immunoassay ; anti-HBc IgM ; Immunoglobulin M antibody to HBV core ; HBeAg ; Hepatitis B e antigen ; anti-HBs ; Antibody to hepatitis B surface antigen ; anti-HBe ; Antibody to hepatitis B e antigen ; anti-HBc ; total antibody to HBV core ; ALT ; Alanine aminotransferase ; AST ; Aspartate aminotransferase ; TBiL ; Total bilirubin
• 刊名：Clinics and Research in Hepatology and Gastroenterology
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：40
• 期：5
• 页码：584-589
• 全文大小：508 K

文摘

This study was conducted to re-recognize serological change patterns of patients with acute hepatitis B (AHB) by a highly sensitive detection technology, as well as to explore methods to select the optimal treatment opportunity.

Methods

The biochemical and virological parameters of 558 AHB patients were analyzed retrospectively. The serological markers of hepatitis B virus and HBV DNA were detected by electrochemiluminescence immunoassay and automatic real-time fluorescent quantitative PCR, respectively.

Results

At baseline, the positive rate of hepatitis B surface antigen (HBsAg) (86.2%) was significantly higher than the positive rate of HBV DNA (51.9%). Among the 58 patients with HBsAg-negative AHB, 16 were detected with trace amounts of HBV DNA at baseline. At 12 weeks, the HBsAg of 43 cases remained positive, and the mean level of HBsAg was 587.5 IU/mL ± 313.4 IU/mL. A total of 18 patients with HBsAg levels greater than 1500 IU/mL at 12 weeks received interferon α-1b treatment and achieved HBsAg clearance within 24 weeks.

Conclusions

Unlike traditional changing patterns, the clearance of HBV DNA in peripheral circulation for a few patients with AHB occurred later than HBsAg clearance. Detection of HBV DNA in peripheral circulation by highly sensitive detection technology could provide a diagnostic basis for those AHB patients who rapidly achieved HBsAg clearance before achieving HBV DNA clearance in their peripheral circulation and prevent misdiagnosis. Dynamic monitoring of the changes in HBsAg levels through highly sensitive detection technology could be used as a guide for the timely adoption of antiviral treatment with interferon and then AHB chronicity would be prevented.