Value of HBsAg level in dynamic monitoring of disease progression in patients with chronic HBV infection

Objective To investigate the clinical value of HBsAg level in dynamic monitoring of disease progression in patients with chronic HBV infection. Methods A retrospective analysis was performed for the clinical data of 1107 patients with different clinical stages of chronic HBV infection who had not received antiviral therapy at the time of hospitalization in The Second Affiliated Hospital of Anhui Medical University from May 2011 to December 2015, and according to the disease status, they were divided into HBeAg-positive chronic hepatitis B ( CHB) group ( n = 356) , HBeAg-negative CHB group ( n = 264) , compensated liver cirrhosis group ( LC-C group, n = 116) , decompensated liver cirrhosis group ( LC-D group, n = 201) , and primary liver cancer ( PLC) group ( n = 170) . These groups were compared in terms of HBsAg expression and the association between HBsAg and clinical features. An analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t-test was used for further comparison between any two groups; the t-test was used for comparison of continuous data between two groups. The chi-square test was used for comparison of categorical data between these groups. Pearson correlation analysis was also performed. Results There were significant differences in serum HBsAg and HBV DNA level between the HBeAg-positive CHB group, HBeAg-negative CHB group, LC-C group, LC-D group, and PLC group ( F =100. 45 and 86. 26, both P < 0. 001) . The HBeAg-positive CHB group ( n = 502) had significantly higher levels of HBsAg and HBV DNA than the HBeAg-negative CHB group ( n = 605) ( t = 16. 67 and 16. 22, both P < 0. 001) . There were significant differences in HBsAg and HBV DNA levels between the HBeAg-positive CHB group, LC-C group, LC-D group, and PLC group ( F = 42. 92 and 27. 38, both P <0. 001) , as well as between the HBeAg-negative CHB group, LC-C group, LC-D group, and PLC group ( F = 6. 04 and 4. 10, both P <0. 05) . HBV DNA level was significantly different across patients with different HBsAg levels ( < 1000 IU/ml, 1000-20 000 IU/ml, and> 20 000 IU/ml) ( F = 189. 51, P < 0. 001) . In the HBeAg-positive CHB group, HBeAg-negative CHB group, LC-C group, and LC-D group, serum HBsAg level was positively correlated with HBV DNA level ( r = 0. 554, 0. 501, 0. 320, and 0. 432, all P < 0. 001) .Conclusion HBsAg level gradually decreases with disease progression and is closely associated with HBV DNA level. Dynamic monitoring of HBsAg level helps to evaluate disease progression after HBV infection.