Change in HBsAg quantification in the nature history of hepatitis B virus infection and its clinical significance

Objective To investigate the distribution characteristics of HBsAg quantification in different clinical status after chronic hepatitis B virus (HBV) infection and its correlation with HBV DNA level. Methods A cross-sectional study was performed for 268 patients with HBV infection who did not receive antiviral therapy in The Fifth Hospital of Shijiazhuang from January 2013 to December 2015. According to the stage of HBV infection, these patients were divided into immune tolerance group with 29 patients, immune clearance group with 169 patients, low-or non-replication group with 19 patients, and reactivation group with 51 patients. Roche electrochemical luminescence was used to measure serum HBsAg quantification and PCR was used to measure HBV DNA level. Logarithmic transformation was performed for the results of HBsAg quantification and HBV DNA level, and a statistical analysis was performed for the results of different stages. The Kruskal-Wallis H rank sum test was used for the analysis of multiple groups, and the Mann-Whitney U test was used for further comparison between any two groups; a Spearman rank correlation analysis was also performed. Results HBsAg quantification varied in different stages of HBV infection (χ2= 71. 830, P < 0. 001) ; the immune tolerance group had significantly higher HBsAg quantification than the other three groups (all P < 0. 05) , and the immune clearance group had significantly higher HBsAg quantification than the low-replication group and the reactivation group (all P < 0. 05) . There was a significant difference in HBV DNA level between groups (χ2= 117. 028, P <0. 001) ; the immune tolerance group had a significantly higher HBV DNA level than the other three groups (all P < 0. 05) , the immune clearance group had a significantly higher HBV DNA level than the low-replication group and the reactivation group (all P < 0. 05) , and the reactivation group had a significantly higher HBV DNA level than the low-replication group (both P < 0. 05) . HBsAg quantification was correlated with HBV DNA level in immune clearance stage (r = 0. 559, P < 0. 001) and reactivation stage (r = 0. 338, P = 0. 014) . Conclusion HBsAg quantification and HBV DNA level in immune tolerance stage are higher than those in the other three stages, and HBsAg quantification is correlated with HBV DNA level in immune clearance stage and reactivation stage.