Anila Mitre, Blerta Laze and Merije Elezi
Chronic hepatitis B infection increases the risk of developing liver failure, liver cancer or cirrhosis, leading to death in case of bad management of the infection. Polymerase chain reaction assays for measuring HBV DNA has been used for many years for diagnosis and monitoring purposes in patients with chronic hepatitis B, but they are too expensive. Quantitative Hepatitis B Surface Antigen (HBsAg) had been suggested as a similar biomarker with HBV DNA. Recent studies and emerging data have shown that HBsAg levels change dynamically during the natural course of a chronic HBV infection. The aims of this study are to show the correlation between quantitative HBsAg and HBV-DNA levels and to analyze if quantitative HBsAg assay can possibly substitute HBV-DNA assay to optimize the management of chronic hepatitis B patients in our daily clinical practice. A total of 200 samples (52 females and 148 males) from different patients with chronic hepatitis B infection, without starting the treatment, are involved in this study. These specimens were tested for quantitative HBsAg, HbeAg, anti-Hbe, anti-Hbc and anti-Hbc-IgM levels with Cobas 6000 Roche instrument and HBV DNA levels with Cobas Taq Man instrument, at “Intermedica” Medical Clinic, in Tirana, Albania. Furthermore, the results were statistically processed with SPSS program (version 15.0; SPSS, Inc., Chicago, IL). The evaluation of the results showed a different correlation between quantitative HBsAg assay and HBV DNA assay at different phases of chronic hepatitis B infection; at Immune-Tolerant phase (IT), the correlation was good [r=0.676 (p<0.01)]. The quantitative HBsAg and HBV DNA relationship was stable in patients that resulted positive for HBeAg. This means a stable relationship between viral replication and HBsAg levels (ccDNA levels) before the immune-clearance phase. There was no correlation between these assays during the other phases of infection. In conclusion, there is a weak correlation between quantitative HBsAg assay and HBV DNA assay and quantitative HBsAg assay cannot substitute the HBV DNA assay, it cannot be used as the only biomarker for chronic hepatitis B infection.
