Result Patterns and Characteristics of HBeAg and HBV DNA in Patients with Chronic Hepatitis B
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BackgroundDiscrepancies in the results between hepatitis B e-antigen (HBeAg) and hepatitis B virus (HBV) DNA levels pose difficulties in the management of chronic hepatitis B (CHB). This study aims to better understand the different phases of CHB and to detect additional meaningful parameters for CHB patients. MethodsWe collected datasets of HBeAg and HBV DNA levels measured during 2016 and the follow-up results for CHB patients for past 3 years. We analyzed the collected data by applying the definitions of CHB clinical phase and compared the results of semi-quantitative and quantitative HBeAg assays. ResultsAbout 55% of 2,291 result pairs from CHB patients showed qualitative agreement between HBeAg and HBV DNA results. HBeAg (−) CHB was reported in 16.49%, while hepatitis B surface antigen (HBsAg) loss occurred in 0.18% among 1,146 patients annually. HBeAg reversion occurred in 2.74% of 839 patients that experienced HBeAg seroconversion. Patients with HBeAg (+) and HBV DNA (−) showed statistically significant differences in the levels and percentage abnormality of alanine aminotransferase (ALT) based on whether HBV DNA was ‘Target not detected’ or ‘Detected, <LOQ’. A strong correlation (r2=0.9435) was observed between semi-quantitative and quantitative HBeAg assay results. ConclusionsThis study reveals clinically important result patterns during the different phases of CHB. ALT level and percentage abnormality were significantly different based on HBV DNA status in HBeAg (+) and HBV DNA (−) patients. We suggest that clinical laboratories should report ‘HBV DNA (−)’ separately as ‘Target not detected’ and ‘Detected, <LOQ’.
Abstract
BackgroundDiscrepancies in the results between hepatitis B e-antigen (HBeAg) and hepatitis B virus (HBV) DNA levels pose difficulties in the management of chronic hepatitis B (CHB). This study aims to better understand the different phases of CHB and to detect additional meaningful parameters for CHB patients. MethodsWe collected datasets of HBeAg and HBV DNA levels measured during 2016 and the follow-up results for CHB patients for past 3 years. We analyzed the collected data by applying the definitions of CHB clinical phase and compared the results of semi-quantitative and quantitative HBeAg assays. ResultsAbout 55% of 2,291 result pairs from CHB patients showed qualitative agreement between HBeAg and HBV DNA results. HBeAg (−) CHB was reported in 16.49%, while hepatitis B surface antigen (HBsAg) loss occurred in 0.18% among 1,146 patients annually. HBeAg reversion occurred in 2.74% of 839 patients that experienced HBeAg seroconversion. Patients with HBeAg (+) and HBV DNA (−) showed statistically significant differences in the levels and percentage abnormality of alanine aminotransferase (ALT) based on whether HBV DNA was ‘Target not detected’ or ‘Detected, <LOQ’. A strong correlation (r2=0.9435) was observed between semi-quantitative and quantitative HBeAg assay results. ConclusionsThis study reveals clinically important result patterns during the different phases of CHB. ALT level and percentage abnormality were significantly different based on HBV DNA status in HBeAg (+) and HBV DNA (−) patients. We suggest that clinical laboratories should report ‘HBV DNA (−)’ separately as ‘Target not detected’ and ‘Detected, <LOQ’.
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