Evaluation of the Relationship of HBsAg Serum Plasma Values with HBV DNA and Other Serologic Markers in the Diagnosis of Hepatitis B
Yıl 2024,
Cilt: 46 Sayı: 3, 178 - 185, 30.09.2024
Hamdi Karahan
,
Cem Çelik
Öz
Objective: Hepatitis B virus (HBV) infections cause a major public health problem worldwide diagnosis and treatment of HBV infection is an important issue. Detection of HBV DNA by polymerase chain reaction (PCR) and demonstration of viral replication together with serologic and biochemical indicators are very useful in diagnosis and treatment. In this study, we aimed to evaluate the relationship between HBsAg serum concentration values and other serologic parameters related to HBV in the diagnosis of hepatitis B.
Methods: HBsAg, HBV DNA, Anti HBc IgG, Anti HBc IgM, HBeAg, and Anti HBe values obtained from blood sera taken from patients in Sivas Cumhuriyet University Application and Research Hospital Microbiology Laboratory between 2012-2020 were retrospectively analyzed from laboratory records.
Results: A positive correlation was found between HBsAg serum titers and HBV DNA and between HBeAg and HBV DNA. It was found that HBV DNA positivity rates increased as HBsAg titers increased. Similarly, it was found that HBc IgG positivity increased as HBsAg titers increased. HBeAg positivity increased with increasing HBsAg titers up to a certain point, while HBeAg positivity decreased after a certain titer. When HBV DNA results were compared with HBeAg results, the relationship between the two values was found to be significant.
Conclusion: We think that it is useful to investigate the relationship between serum concentrations of HBsAg and HBV DNA and other serologic parameters in the accurate identification of HBV infection and monitoring of treatment.
Etik Beyan
Each stage of the study was conducted with ethical principles. Before the application, the necessary permissions were obtained from the Sivas Cumhuriyet University Non-Interventional Clinical Research Ethics Committee (dated 25.05.2022, numbered 11/41)
Kaynakça
- 1. Martyn E, Eisen S, Longley N, et al. The forgotten people: Hepatitis B virus (HBV) infection as a priority for the inclusion health agenda. Elife. 2023; 12:e81070. doi: 10.7554/eLife.81070.
- 2. Güçlü E, Geyik MF. Hepatitis B infection and prevention. Konuralp Med J. 2012; 4(2): 54-58.
- 3. Rizzo GEM, Cabibbo G, Craxì A. Hepatitis B virus-associated hepatocellular carcinoma. Viruses. 202214(5):986. doi: 10.3390/v14050986.
- 4. Akhan S, Aynıoğlu A, Çağatay A, et al. Management of chronic hepatitis B virus infection: A consensus report of the study group for viral hepatitis of the Turkish society of clinical microbiology and infectious diseases. Klimik Derg. 2014; 27(Suppl 1):2-18. doi: 10.5152/kd.2014.26
- 5. Guvenir M, Arikan A. Hepatitis B virus: from diagnosis to treatment. Pol J Microbiol. 2020;69(4):391-399. doi: 10.33073/pjm-2020-044.
- 6. Nguyen T, Desmond P, Locarnini S. The role of quantitative hepatitis B serology in the natural history and management of chronic hepatitis B. Hepatol Int. 2009;3(Suppl 1):5-15. doi: 10.1007/s12072-009-9149-7.
- 7. Terrault NA, Lok AS, McMahon BJ, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology. 2018;67:1560–1599. doi: 10.1002/hep.29800.
- 8. Krajden M, McNabb G, Petric M. The laboratory diagnosis of hepatitis B virus. Can J Infect Dis Med Microbiol. 2005;16(2):65-72. doi: 10.1155/2005/450574.
- 9. Uysal RC, Çalık BY, Tercan U, Arslantaş, D. Hepatitis B &Hepatitis C infections. Türk Tıp Öğrencileri Araştırma Dergisi. 2020;2(2):108-112.
- 10. Leowattana W, Leowattana T. Chronic hepatitis B: New potential therapeutic drugs target. World J Virol. 2022;11(1):57-72. doi: 10.5501/wjv.v11.i1.57.
- 11. Sağlık I, Mutlu D, Öngüt G, et al. Comparison of HBsAg and HBeAg levels with HBV DNA and ALT levels in patients with chronic hepatitis B infections. Viral Hepat J. 2013;19(3):119-122. doi:10.4274Vhd.84856.
- 12. Zhu HY, Zhang XS. Relationship between HBV DNA load and levels of serum HBsAg in patients with chronic hepatitis B. Eur Rev Med Pharmacol Sci. 2016;20(10):2061-2064.
- 13. Demirelli M, Tülek N, Temocin F, Yücel D, Erdinç Ş, Ertem G. Investigation of the association of serum quantitative HBsAg levels with viral load in chronic hepatitis B patients receiving treatment. Pamukkale Med J. 2020;13(3): 569-578. doi.org/10.31362/patd.691645.
- 14. Karra VK, Chowdhury SJ, Ruttala R, Polipalli SK, Kar P. Clinical significance of quantitative HBsAg titres and its correlation with HBV DNA levels in the natural history of hepatitis B virus infection. J Clin Exp Hepatol. 2016;6(3):209-215. doi: 10.1016/j.jceh.2016.07.002.
- 15. Ozaras R, Tabak F, Tahan V, et al. Correlation of quantitative assay of HBsAg and HBV DNA levels during chronic HBV treatment. Dig Dis Sci. 2008;53(11):2995-2998. doi: 10.1007/s10620-008-0263-5.
- 16. Shao J, Wei L, Wang H, et al. Relationship between hepatitis B virus DNA levels and liver histology in patients with chronic hepatitis B. World J Gastroenterol. 2007;13(14):2104-2107. doi: 10.3748/wjg.v13.i14.2104.
- 17. Wang N, Zheng J, Huang Y, Pu X, Jiang L, Yang J. A Predictive model to evaluate the HbeAg positivity of chronic hepatitis B virus patients in clinics: A cross-sectional study. Medicina (Kaunas). 2022;58(9):1279. doi: 10.3390/medicina58091279.
- 18. Çeviker SA, Günal Ö, Kılıç SS, Köksal E. The relationship between serum HBV DNA levels, Hbeag status, biochemical parameters, liver ınflammation and fibrosis severity in patients with chronic hepatitis B. KSU Med J. 2020;15(1):32-36. doi.org/10.17517/ksutfd.566288
- 19. Martinot-Peignoux M, Lapalus M, Laouénan C, et al. Prediction of disease reactivation in asymptomatic hepatitis B e antigen-negative chronic hepatitis B patients using baseline serum measurements of HBsAg and HBV-DNA. J Clin Virol. 2013;58(2):401-407. doi: 10.1016/j.jcv.2013.08.010.
- 20. Akın P, Özbay G, Şentürk H, et al. Asyptomatic “healthy” HBsAg carrier state in Turkey. Cerrahpaşa J Med.1998;29(3):141-144.
- 21. Tezcan Ülger S, Delialioğlu N, Kandemir Ö, Ovla Çelikcan HD. Quantitative determination of HBsAg levels in chronically infected patients with hepatitis B virus. Türk Mikrobiyol Cem Derg. 2018;48(1):60-65. doi:10.5222/TMCD.2018.060.
- 22. Savcı Ü, Bulut Y. Polymerase chain reaction with investigation of occult Hepatitis B infection in hemodialysis patients. Turk J Clin Lab. 2015;6(1):19-23.
- 23. Svicher V, Cento V, Bernassola M, et al. Novel HBsAg markers tightly correlate with occult HBV infection and strongly affect HBsAg detection. Antiviral Res. 2012;93(1):86-93. doi: 10.1016/j.antiviral.2011.10.022.
- 24. Bozdemir T, Zeytinoğlu Türkeş A, Sertöz R, Altuğlu İ. Evaluation of 'anti-HBc only' serological pattern detected in patients admitted to Ege University Hospital. Ege Journal of Medicine. 2016;55(4):180-183.
Hepatit B Tanısında HBsAg Serum Plazma Değerlerinin HBV DNA ve Diğer Serolojik Belirteçlerle İlişkisinin Değerlendirilmesi
Yıl 2024,
Cilt: 46 Sayı: 3, 178 - 185, 30.09.2024
Hamdi Karahan
,
Cem Çelik
Öz
Amaç: Hepatit B virüsü (HBV) enfeksiyonları tüm dünyada çok önemli bir toplum sağlığı problemi oluşturmaktadır. HBV enfeksiyonunun tanı ve tedavisi önemli bir konudur. HBV DNA’nın polimeraz zincir reaksiyonu (PCR) yöntemi ile saptanarak viral replikasyonun gösterilmesi, serolojik ve biyokimyasal göstergelerle birlikte tanı ve tedavinin takibinde oldukça yararlıdır. Bu çalışmada, Hepatit B tanısında HBsAg serum konsantrasyon değerlerinin, HBV ile ilgili diğer serolojik parametreler ile karşılaştırılarak aralarındaki ilişkinin değerlendirilmesi amaçlanmıştır.
Yöntem: Sivas Cumhuriyet Üniversitesi Uygulama ve Araştırma Hastanesi Mikrobiyoloji Laboratuvarına 2012–2020 yıllarında hastalardan alınan kan serumlarından elde edilen HBsAg, HBV DNA, Anti HBc IgG, Anti HBc IgM, HBeAg ve Anti HBe değerleri laboratuvar kayıtlarından geriye dönük olarak incelenmiştir.
Bulgular: HBsAg serum titreleri ile HBV DNA arasında ve HBeAg ile HBV DNA arasında pozitif bir ilişki bulunmuştur. HBsAg titreleri arttıkça HBV DNA pozitiflik oranlarının arttığı görülmüştür. Aynı şekilde HBsAg titreleri arttıkça HBc IgG pozitifliklerinin arttığı tespit edilmiştir. Belirli bir noktaya kadar artan HBsAg titreleri ile HBeAg pozitifliği artarken, belirli bir titreden sonra HBeAg pozitifliği düşmüştür. HBV DNA sonuçları ile HBeAg sonuçları karşılaştırıldığında iki değer arasındaki ilişki önemli bulunmuştur.
Sonuç: HBV enfeksiyonun doğru bir şekilde tanımlanmasında ve tedavinin izlenmesinde HBsAg’nin serum konsantrasyonlarının, HBV DNA ve diğer serolojik parametreler ile ilişkilerinin araştırılmasının yararlı olduğunu düşünmekteyiz.
Kaynakça
- 1. Martyn E, Eisen S, Longley N, et al. The forgotten people: Hepatitis B virus (HBV) infection as a priority for the inclusion health agenda. Elife. 2023; 12:e81070. doi: 10.7554/eLife.81070.
- 2. Güçlü E, Geyik MF. Hepatitis B infection and prevention. Konuralp Med J. 2012; 4(2): 54-58.
- 3. Rizzo GEM, Cabibbo G, Craxì A. Hepatitis B virus-associated hepatocellular carcinoma. Viruses. 202214(5):986. doi: 10.3390/v14050986.
- 4. Akhan S, Aynıoğlu A, Çağatay A, et al. Management of chronic hepatitis B virus infection: A consensus report of the study group for viral hepatitis of the Turkish society of clinical microbiology and infectious diseases. Klimik Derg. 2014; 27(Suppl 1):2-18. doi: 10.5152/kd.2014.26
- 5. Guvenir M, Arikan A. Hepatitis B virus: from diagnosis to treatment. Pol J Microbiol. 2020;69(4):391-399. doi: 10.33073/pjm-2020-044.
- 6. Nguyen T, Desmond P, Locarnini S. The role of quantitative hepatitis B serology in the natural history and management of chronic hepatitis B. Hepatol Int. 2009;3(Suppl 1):5-15. doi: 10.1007/s12072-009-9149-7.
- 7. Terrault NA, Lok AS, McMahon BJ, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology. 2018;67:1560–1599. doi: 10.1002/hep.29800.
- 8. Krajden M, McNabb G, Petric M. The laboratory diagnosis of hepatitis B virus. Can J Infect Dis Med Microbiol. 2005;16(2):65-72. doi: 10.1155/2005/450574.
- 9. Uysal RC, Çalık BY, Tercan U, Arslantaş, D. Hepatitis B &Hepatitis C infections. Türk Tıp Öğrencileri Araştırma Dergisi. 2020;2(2):108-112.
- 10. Leowattana W, Leowattana T. Chronic hepatitis B: New potential therapeutic drugs target. World J Virol. 2022;11(1):57-72. doi: 10.5501/wjv.v11.i1.57.
- 11. Sağlık I, Mutlu D, Öngüt G, et al. Comparison of HBsAg and HBeAg levels with HBV DNA and ALT levels in patients with chronic hepatitis B infections. Viral Hepat J. 2013;19(3):119-122. doi:10.4274Vhd.84856.
- 12. Zhu HY, Zhang XS. Relationship between HBV DNA load and levels of serum HBsAg in patients with chronic hepatitis B. Eur Rev Med Pharmacol Sci. 2016;20(10):2061-2064.
- 13. Demirelli M, Tülek N, Temocin F, Yücel D, Erdinç Ş, Ertem G. Investigation of the association of serum quantitative HBsAg levels with viral load in chronic hepatitis B patients receiving treatment. Pamukkale Med J. 2020;13(3): 569-578. doi.org/10.31362/patd.691645.
- 14. Karra VK, Chowdhury SJ, Ruttala R, Polipalli SK, Kar P. Clinical significance of quantitative HBsAg titres and its correlation with HBV DNA levels in the natural history of hepatitis B virus infection. J Clin Exp Hepatol. 2016;6(3):209-215. doi: 10.1016/j.jceh.2016.07.002.
- 15. Ozaras R, Tabak F, Tahan V, et al. Correlation of quantitative assay of HBsAg and HBV DNA levels during chronic HBV treatment. Dig Dis Sci. 2008;53(11):2995-2998. doi: 10.1007/s10620-008-0263-5.
- 16. Shao J, Wei L, Wang H, et al. Relationship between hepatitis B virus DNA levels and liver histology in patients with chronic hepatitis B. World J Gastroenterol. 2007;13(14):2104-2107. doi: 10.3748/wjg.v13.i14.2104.
- 17. Wang N, Zheng J, Huang Y, Pu X, Jiang L, Yang J. A Predictive model to evaluate the HbeAg positivity of chronic hepatitis B virus patients in clinics: A cross-sectional study. Medicina (Kaunas). 2022;58(9):1279. doi: 10.3390/medicina58091279.
- 18. Çeviker SA, Günal Ö, Kılıç SS, Köksal E. The relationship between serum HBV DNA levels, Hbeag status, biochemical parameters, liver ınflammation and fibrosis severity in patients with chronic hepatitis B. KSU Med J. 2020;15(1):32-36. doi.org/10.17517/ksutfd.566288
- 19. Martinot-Peignoux M, Lapalus M, Laouénan C, et al. Prediction of disease reactivation in asymptomatic hepatitis B e antigen-negative chronic hepatitis B patients using baseline serum measurements of HBsAg and HBV-DNA. J Clin Virol. 2013;58(2):401-407. doi: 10.1016/j.jcv.2013.08.010.
- 20. Akın P, Özbay G, Şentürk H, et al. Asyptomatic “healthy” HBsAg carrier state in Turkey. Cerrahpaşa J Med.1998;29(3):141-144.
- 21. Tezcan Ülger S, Delialioğlu N, Kandemir Ö, Ovla Çelikcan HD. Quantitative determination of HBsAg levels in chronically infected patients with hepatitis B virus. Türk Mikrobiyol Cem Derg. 2018;48(1):60-65. doi:10.5222/TMCD.2018.060.
- 22. Savcı Ü, Bulut Y. Polymerase chain reaction with investigation of occult Hepatitis B infection in hemodialysis patients. Turk J Clin Lab. 2015;6(1):19-23.
- 23. Svicher V, Cento V, Bernassola M, et al. Novel HBsAg markers tightly correlate with occult HBV infection and strongly affect HBsAg detection. Antiviral Res. 2012;93(1):86-93. doi: 10.1016/j.antiviral.2011.10.022.
- 24. Bozdemir T, Zeytinoğlu Türkeş A, Sertöz R, Altuğlu İ. Evaluation of 'anti-HBc only' serological pattern detected in patients admitted to Ege University Hospital. Ege Journal of Medicine. 2016;55(4):180-183.