Conclusions: Serum HBsAg levels correlates well with serum HBV DNA levels in patients with chronic Hepatitis B. Serum HBsAg level can reliably used for diagnosing high HBV DNA level.
i do agree but this is only at low levels of hbsag especially those less than 1500iu/ml...they ll never apply this because hbvdna is much more expensive than hbsag quant, this will also show that nuc therapy mainly worsen hbsag levels
Background: Measurement of serum hepatitis B virus (HBV) DNA levels is an integral part in diagnosis and monitoring of patients of chronic hepatitis B. Commercially available HBV DNA assays lack standardization and uniformity, are cumbersome needing high expertise and very expensive. Recent studies have suggested that quantitative serum hepatitis B surface antigen (HBsAg) levels can be used in place of HBV DNA levels to monitor treatment outcome. However, the data correlating HBV DNA levels with HBsAg levels are scarce. Aim: To correlate HBV DNA levels with HBsAg levels in patients with chronic HBV infection. Patients and Methods: Consecutive patients of chronic HBV infection (both naïve and on-treatment) attending the out-patient clinic of Institute of Liver & Biliary Sciences (ILBS) were included. Patients with undetectable HBV DNA levels were excluded. HBV DNA quantitation was done on patient’s plasma (500µl) on COBAS TaqMan HBV test with high pure extraction (Roche Diagnostics) as per the manufactures protocol. Results were expressed as IU/ml. Lower limit of detection for the assay is 6 IU/ml and linear range 29 to 1.1×108 IU/ml. HBsAg levels were done by the Architect HBsAg QT (Abbott) assay as per the manufactures protocol and results were expressed as IU/mL. Non-parametric two-tailed Spearman’s test was used to correlate HBV DNA and HBsAg levels. Results: A total of 73 patients were included in the study (mean age 43±14 years, 82% males). Of them 43 (59%) were treatment-naïve and 30 (41%) were on treatment with antiviral drugs. Thirty-four (47%) were HBeAg positive and rest were negative. Fifty-seven (78%) patients were chronic hepatitis and rest had cirrhosis. The median HBV DNA level was 104 (range 10 to 108) IU/mL. Forty-three (59%) patients had high HBV DNA levels (≥2000 IU/mL). The median HBsAg level was 12752 (range 5 to 125000) IU/mL. There was significant correlation between HBV DNA levels and HBsAg levels (Spearman’s rho 0.458, p value <0.001). On receiver operating characteristics curve the area under the curve for HBsAg level for diagnosing high HBV DNA level was 0.762 (95% CI 0.653, 0.872; p<0.01) (Figure). Conclusions: Serum HBsAg levels correlates well with serum HBV DNA levels in patients with chronic Hepatitis B. Serum HBsAg level can reliably used for diagnosing high HBV DNA level.
when hsag is lower than 1500iu/ml the most have normal/near normal alt and hbvdna 3logs, in particular they have immune control of infection
the contrary has no correlation....hbvdna undetactable is not correlated to low hbsag or immune control and sometimes even alt are not normal, i think this is the reason for not considering hbvdna undetactable
in this http://trs.scivee.tv/node/1198 they say that modest correlation (HBeAG +) or very week correlation (HBeAG -) between HBV DNA and qHBsAG was foud and also say that qHBsAG is decrees under tx (ETV) (only 3 patients increase qHBsAG under tx)
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In my opinion,
1. Low qHBsAg < 250 IU/mL (as Stef2011 stated) predicts a good chance of clearing HBsAg, meaning your treatment is working well or that you don't need treatment.
2. qHBsAg before and during treatment, can predict whether the treatment is working, that you should continue or switch (especially true for Inteferon).
3. Assay for qHBsAg is cheaper than that for hbvdna - so can qHBsAg replace hbvdna as a diagnostic and/or monitoring assay? In my opinion, no. We need both.
4. At the moment patients in Australia and America cannot ask for qHBsAg, because, I suspect, the interpretation of the result is not precise enough. But qHBsAg is certainly used in scientific and clinical studies by doctors and scientists. It is a valuable tool.
Bottom line, qHBsAg levels have meanings, and scientists are working to understand them.
if that is significalntly decrease even air or normal decrease by time is ok.to me that's really nothing on hbeag neg....a significant deacrease of hbsag is when it reaches 1log or goes down continuatively like 0,5log per year
alinia beats both interferon and etv in this although like both inf and etv there are many non responders and also hbsag goes up and down but never undetactable, at least in our experience of less than 2 years
this is the link (I just try a copy paste and it work from my side).
I only point out the other study that say that the qHBsAg and DNA are not correlated, but I'm totally agree with StephenCastlecrag that the qHBsAg representing something and it worth to be study and for now we can say that the qHBsAg can say something about the tx.
you are right, more and more scientific papers look over the qHBsAg so it seams that this will be a important marker for the future.
Anyway, this is somehow normal, the aim of the tx is HBsAg seroconversion so the quantity is important.
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