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HbsAg seviyesinin HBV DNA ve karaciğer fibrozisi ile ilişkisi

Yıl 2023, Cilt: 22 Sayı: 1, 13 - 19, 30.04.2023
https://doi.org/10.17941/agd.1273939

Öz

Giriş ve Amaç: Kovalent olarak kapalı dairesel DNA düzeyinin kronik hepatit B hastalarında hastalığın aktivitesini öngörmede klinik önemi bulunmaktadır. Kovalent olarak kapalı dairesel DNA düzeyinin dolaylı bir göstergesi olan hepatit B yüzey antijeni düzeyi, kronik hepatit B hastalarının yönetiminde hepatit B virüs-DNA düzeyi ile birlikte önemli rol alabilir. Çalışmamızda, hepatit B nedeni ile karaciğer biyopsisi yapılan hastaların fibrozis skorları, hepatit B virüs-DNA ve hepatit B yüzey antijeni seviyelerinin hepatit B zarf antijeni durumu dikkate alınarak kıyaslanması amaçlandı. Gereç ve Yöntem: 2017-2020 yılları arasında kronik hepatit B nedeni ile karaciğer biyopsisi yapılan hastaların biyopsi sonuçları, retrospektif kesitsel olarak değerlendirildi. Biyopsi sonucunda fibrozis değerleri hepatit B zarf antijeni durumu göz önüne alınarak değerlendirildi. Bulgular: Çalışma grubunu 71 (%55.4) erkek, 57 (%44.5) kadın toplam 128 hasta oluşturdu. Ortalama yaş erkeklerde 41.58 ± 14.27, kadınlarda 43.63 ± 12.13 idi (p: 0.38). Hepatit B zarf antijeni pozitif hastalarda hepatit B yüzey antijeninin hepatit B virüs-DNA (p: <0.01, r: 0.46), nekroinflamatuvar aktivite (p: 0.03, r: -0.38) ve fibrozis (p: <0.01, r: -0.73) ile korele olduğu görüldü. Hepatit B zarf antijeni negatif hastalarda hepatit B yüzey antijen seviyesi fibrozis ile ilişkili olarak saptanmadı. Ancak ileri fibrozisi olan hastalarda hafif fibrozisi olanlara göre hepatit B virüs-DNA anlamlı olarak yüksek (p: <0.01) beraberinde hepatit B yüzey antijeni seviyeleri ise anlamlı olarak daha düşük saptandı (p: <0.01). Sonuç: Hepatit B yüzey antijeni seviyeleri hepatit B zarf antijeni pozitif hastalarda fibrozisi ön görmede faydalı olmakla birlikte hepatit B yüzey antijeni negatif hastalarda fibrozisi öngörmede başarısı hepatit B zarf antijeni pozitif hastalar kadar iyi saptanmamıştır.

Kaynakça

  • 1. Zampino R, Boemio A, Sagnelli C, et al. Hepatitis B virus burden in developing countries. World J Gastroenterol 2015;21:11941-53.
  • 2. European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu; European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol 2017;67:370-98.
  • 3. Seeger C, Mason WS. Hepatitis B virus biology. Microbiol Mol Biol Rev 2000;64:51-68.
  • 4. Liaw YF. Clinical utility of hepatitis B surface antigen quantitation in patients with chronic hepatitis B: A review. Hepatology 2011;54:E1-9.
  • 5. Cornberg M, Wong VWS, Locarnini S, et al. The role of quantitative hepatitis B surface antigen revisited. J Hepatol 2017;66:398-411.
  • 6. Liu SQ, Zhu XJ, Sun XH, Li M, Gao YQ. [Characteristic of liver pathology in HBeAg-positive and HBeAg-negative chronic hepatitis B patients with mildly elevated ALT]. Zhonghua Gan Zang Bing Za Zhi 2012;20:348-52.
  • 7. Zeng DW, Liu YR, Dong J, et al. Serum HBsAg and HBeAg levels are associated with liver pathological stages in the immune clearance phase of hepatitis B virus chronic infection. Mol Med Rep 2015;11:3465-72.
  • 8. Nguyen T, Thompson AJV, Bowden S, et al. Hepatitis B surface antigen levels during the natural history of chronic hepatitis B: A perspective on Asia. J Hepatol 2010;52:508-13.
  • 9. Zeng LY, Lian JS, Chen JY, et al. Hepatitis B surface antigen levels during natural history of chronic hepatitis B: A Chinese perspective study. World J Gastroenterol 2014;20:9178-84.
  • 10. Viganò M, Lampertico P. Clinical implications of HBsAg quantification in patients with chronic hepatitis B. Saudi J Gastroenterol 2012;18:81-6.
  • 11. Li J, Sun X, Fang J, et al. Analysis of intrahepatic total HBV DNA, cccDNA and serum HBsAg level in Chronic Hepatitis B patients with undetectable serum HBV DNA during oral antiviral therapy. Clin Res Hepatol Gastroenterol 2017;41:635-43.
  • 12. Wiegand J, Wedemeyer H, Finger A, et al. A decline in hepatitis B virus surface antigen (HBsAg) predicts clearance, but does not correlate with quantitative HBeAg or HBV DNA levels. Antivir Ther 2008;13:547-54.
  • 13. Ishak K, Baptista A, Bianchi L, et al. Histological grading and staging of chronic hepatitis. J Hepatol 1995;22:696-9.
  • 14. Chan HL, Wong VW, Wong GL, et al. A longitudinal study on the natural history of serum hepatitis B surface antigen changes in chronic hepatitis B. Hepatology 2010;52:1232-41.
  • 15. Martinot-Peignoux M, Carvalho-Filho R, Lapalus M, et al. Hepatitis B surface antigen serum level is associated with fibrosis severity in treatment-naïve, e antigen-positive patients. J Hepatol 2013;58:1089-95.
  • 16. Marcellin P, Martinot-Peignoux M, Asselah T, et al. Serum levels of hepatitis B surface antigen predict severity of fibrosis in patients with E antigen-positive chronic hepatitis B. Clin Gastroenterol Hepatol 2015;13:1532-9.e1.
  • 17. Jaroszewicz J, Serrano BC, Wursthorn K, et al. Hepatitis B surface antigen (HBsAg) levels in the natural history of hepatitis B virus (HBV)-infection: a European perspective. J Hepatol 2010;52:514-22.
  • 18. Tseng T, Liu C, Su T, et al. Serum hepatitis B surface antigen levels predict surface antigen loss in hepatitis B e antigen seroconverters. Gastroenterology 2011;141:517-25.
  • 19. Fung J, Wong DKH, Seto WK, et al. Hepatitis B surface antigen seroclearance: Relationship to hepatitis B e-antigen seroclearance and hepatitis B e-antigen-negative hepatitis. Am J Gastroenterol 2014;109:1764-70.
  • 20. Yakut M, Bektas M, Seven G, et al. Characterization of the inactive HBsAg carrier state with 3 year follow-up. J Hepatol 2011;54(Suppl 1):S159.
  • 21. Brunetto MR, Oliveri F, Colombatto P, et al. Hepatitis B surface antigen serum levels help to distinguish active from inactive hepatitis B virus genotype D carriers. Gastroenterology 2010;139:483-90.
  • 22. Liu J, Yang H, Lee M, et al. Serum levels of hepatitis B surface antigen and DNA can predict inactive carriers with low risk of disease progression. Hepatology 2016;64:381-9.
  • 23. Papatheodoridis GV, Manesis EK, Manolakopoulos S, et al. Is there a meaningful serum hepatitis B virus DNA cutoff level for therapeutic decisions in hepatitis B e antigen-negative chronic hepatitis B virus infection? Hepatology 2008;48:1451-9.

The relationship of HbsAg level with HBV DNA and liver fibrosis

Yıl 2023, Cilt: 22 Sayı: 1, 13 - 19, 30.04.2023
https://doi.org/10.17941/agd.1273939

Öz

Backgorund and Aims: The level of covalently closed circular DNA has clinical significance in predicting the activity of the disease in patients with chronic hepatitis B. Hepatitis B surface antigen level, which is an indirect indicator of covalently closed circular DNA level, may play an important role together with hepatitis B virus-DNA level in the management of chronic hepatitis B patients. In this study, it was aimed to compare the fibrosis scores, hepatitis B virus-DNA and hepatitis B surface antigen titers of the patients who underwent liver biopsy due to hepatitis B, taking into account the hepatitis B e-antigen status. Materials and Method: Biopsy results of patients who underwent liver biopsy for chronic hepatitis B between 2017-2020 were evaluated retrospectively, cross-sectionally. Fibrosis values in biopsy results were evaluated considering Hepatitis B e-antigen status. Results: The study group consisted of 128 patients, 71 (55.4%) male and 57 (44.5%) female. The mean age was 41.58 ± 14.27 in men and 43.63 ± 12.13 in women (p: 0.38). In hepatitis B e-antigen positive patients, hepatitis B surface antigen was found to be correlated with hepatitis B virus-DNA (p: < 0.01, r: 0.46), necroinflammatory activity (p: 0.03, r: -0.38) and fibrosis (p: < 0.01, r: -0.73). In hepatitis B e-antigen negative patients, hepatitis B surface antigen was not found to be associated with fibrosis. However, patients with advanced fibrosis had significantly higher hepatitis B virus-DNA (p: < 0.01) and hepatitis B surface antigen titers were significantly lower (p: < 0.01) compared to patients with mild fibrosis. Conclusion: Although hepatitis B surface antigen titers are useful in predicting fibrosis in hepatitis B e-antigen positive patients, its success in predicting fibrosis in hepatitis B surface antigen negative patients was not as good as in hepatitis B e-antigen positive patients.

Kaynakça

  • 1. Zampino R, Boemio A, Sagnelli C, et al. Hepatitis B virus burden in developing countries. World J Gastroenterol 2015;21:11941-53.
  • 2. European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu; European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol 2017;67:370-98.
  • 3. Seeger C, Mason WS. Hepatitis B virus biology. Microbiol Mol Biol Rev 2000;64:51-68.
  • 4. Liaw YF. Clinical utility of hepatitis B surface antigen quantitation in patients with chronic hepatitis B: A review. Hepatology 2011;54:E1-9.
  • 5. Cornberg M, Wong VWS, Locarnini S, et al. The role of quantitative hepatitis B surface antigen revisited. J Hepatol 2017;66:398-411.
  • 6. Liu SQ, Zhu XJ, Sun XH, Li M, Gao YQ. [Characteristic of liver pathology in HBeAg-positive and HBeAg-negative chronic hepatitis B patients with mildly elevated ALT]. Zhonghua Gan Zang Bing Za Zhi 2012;20:348-52.
  • 7. Zeng DW, Liu YR, Dong J, et al. Serum HBsAg and HBeAg levels are associated with liver pathological stages in the immune clearance phase of hepatitis B virus chronic infection. Mol Med Rep 2015;11:3465-72.
  • 8. Nguyen T, Thompson AJV, Bowden S, et al. Hepatitis B surface antigen levels during the natural history of chronic hepatitis B: A perspective on Asia. J Hepatol 2010;52:508-13.
  • 9. Zeng LY, Lian JS, Chen JY, et al. Hepatitis B surface antigen levels during natural history of chronic hepatitis B: A Chinese perspective study. World J Gastroenterol 2014;20:9178-84.
  • 10. Viganò M, Lampertico P. Clinical implications of HBsAg quantification in patients with chronic hepatitis B. Saudi J Gastroenterol 2012;18:81-6.
  • 11. Li J, Sun X, Fang J, et al. Analysis of intrahepatic total HBV DNA, cccDNA and serum HBsAg level in Chronic Hepatitis B patients with undetectable serum HBV DNA during oral antiviral therapy. Clin Res Hepatol Gastroenterol 2017;41:635-43.
  • 12. Wiegand J, Wedemeyer H, Finger A, et al. A decline in hepatitis B virus surface antigen (HBsAg) predicts clearance, but does not correlate with quantitative HBeAg or HBV DNA levels. Antivir Ther 2008;13:547-54.
  • 13. Ishak K, Baptista A, Bianchi L, et al. Histological grading and staging of chronic hepatitis. J Hepatol 1995;22:696-9.
  • 14. Chan HL, Wong VW, Wong GL, et al. A longitudinal study on the natural history of serum hepatitis B surface antigen changes in chronic hepatitis B. Hepatology 2010;52:1232-41.
  • 15. Martinot-Peignoux M, Carvalho-Filho R, Lapalus M, et al. Hepatitis B surface antigen serum level is associated with fibrosis severity in treatment-naïve, e antigen-positive patients. J Hepatol 2013;58:1089-95.
  • 16. Marcellin P, Martinot-Peignoux M, Asselah T, et al. Serum levels of hepatitis B surface antigen predict severity of fibrosis in patients with E antigen-positive chronic hepatitis B. Clin Gastroenterol Hepatol 2015;13:1532-9.e1.
  • 17. Jaroszewicz J, Serrano BC, Wursthorn K, et al. Hepatitis B surface antigen (HBsAg) levels in the natural history of hepatitis B virus (HBV)-infection: a European perspective. J Hepatol 2010;52:514-22.
  • 18. Tseng T, Liu C, Su T, et al. Serum hepatitis B surface antigen levels predict surface antigen loss in hepatitis B e antigen seroconverters. Gastroenterology 2011;141:517-25.
  • 19. Fung J, Wong DKH, Seto WK, et al. Hepatitis B surface antigen seroclearance: Relationship to hepatitis B e-antigen seroclearance and hepatitis B e-antigen-negative hepatitis. Am J Gastroenterol 2014;109:1764-70.
  • 20. Yakut M, Bektas M, Seven G, et al. Characterization of the inactive HBsAg carrier state with 3 year follow-up. J Hepatol 2011;54(Suppl 1):S159.
  • 21. Brunetto MR, Oliveri F, Colombatto P, et al. Hepatitis B surface antigen serum levels help to distinguish active from inactive hepatitis B virus genotype D carriers. Gastroenterology 2010;139:483-90.
  • 22. Liu J, Yang H, Lee M, et al. Serum levels of hepatitis B surface antigen and DNA can predict inactive carriers with low risk of disease progression. Hepatology 2016;64:381-9.
  • 23. Papatheodoridis GV, Manesis EK, Manolakopoulos S, et al. Is there a meaningful serum hepatitis B virus DNA cutoff level for therapeutic decisions in hepatitis B e antigen-negative chronic hepatitis B virus infection? Hepatology 2008;48:1451-9.
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Ahmet Ramiz Baykan Bu kişi benim 0000-0001-6798-0240

Elmas Kasap Bu kişi benim 0000-0002-4335-1156

Yayımlanma Tarihi 30 Nisan 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 22 Sayı: 1

Kaynak Göster

APA Baykan, A. R., & Kasap, E. (2023). HbsAg seviyesinin HBV DNA ve karaciğer fibrozisi ile ilişkisi. Akademik Gastroenteroloji Dergisi, 22(1), 13-19. https://doi.org/10.17941/agd.1273939

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