Hepatitis B Surface Antigen Levels Can Be Used to Rule Out Cirrhosis in Hepatitis B e Antigen-Positive Chronic Hepatitis B: Results From the SONIC-B Study. (21st April 2020)

• Record Type: Journal Article
• Authors: Sonneveld, Milan J; Hansen, Bettina E; Brouwer, Willem P; Chan, Henry L-Y; Piratvisuth, Teerha; Jia, Ji-Dong; Zeuzem, Stefan; Chien, Rong-Nan; de Knegt, Robert J; Wat, Cynthia; Pavlovic, Vedran; Gaggar, Anuj; Xie, Qing; Buti, Maria; de Man, Robert A; Janssen, Harry L A
• Is Part Of: Journal of infectious diseases. Volume 225:Number 11(2022)
• Page Start: 1967
• Page End: 1973
• Publication Date: 2020-04-21
• Subjects: cirrhosis -- fibrosis -- hepatitis B -- HBsAg; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiaa192
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Background: Serum hepatitis B surface antigen (HBsAg) levels correlate with the duration of chronic hepatitis B virus (HBV) infection and may predict the extent of hepatic fibrosis. Methods: We analyzed data from the SONIC-B database, which contains data from 8 global randomized trials and 2 large hepatology centers. Relationship between HBsAg levels and presence of significant fibrosis (Ishak 3–4) or cirrhosis (Ishak 5–6) were explored, and clinically relevant cutoffs were identified to rule out cirrhosis. Results: The dataset included 2779 patients: 1866 hepatitis B e antigen (HBeAg)-positive; 322 with cirrhosis. Among HBeAg-positive patients, lower HBsAg levels were associated with higher rates of significant fibrosis (odds ratio [OR], 0.419; P < .001) and cirrhosis (OR, 0.435; P < .001). No relationship was observed among HBeAg-negative patients. Among HBeAg-positive patients, genotype-specific HBsAg cutoffs had excellent negative predictive values (>97%) and low misclassification rates (≤7.1%) and may therefore have utility in ruling out cirrhosis. Diagnostic performance of the HBsAg cutoffs was comparable among patients in whom cirrhosis could not be ruled out with fibrosis 4 (FIB-4). Conclusions: Hepatitis B virus genotype-specific HBsAg cutoffs may have utility in ruling out presence of cirrhosis in HBeAg-positive patients with genotypes B, C, and D and can be an adjunct to FIB-4 to reduce the need for further testing. Abstract : In a multicenter study of 2779 untreated chronic hepatitis B patients, lower HBsAg levels were shown to predict presence of advanced fibrosis in patients with HBeAg-positive disease. HBV genotype-specific HBsAg cutoffs can be used to rule out cirrhosis.