Evaluation of serum hepatitis B surface antigen quantification kinetics in different patterns of chronic hepatitis B infection

Background and aim Management of chronic hepatitis B (CHB) infection is challenging owing to its wide immunologic phases and pathologic patterns. Quantification of serum HBs‑Ag (qHBsAg) has been used as a mirror of intrahepatic viral replication, and therefore, its kinetics in these patterns may reflect diseases severity and hence may help in tailoring the management plan. So, this study was designed to assess the patterns and kinetics of qHBsAg among Egyptian patients presented with different forms of CHB. Patients and methods Between December 2016 and December 2017, patients with CHB were enrolled and categorized into three groups. Group I included naive aviremic patients [those with negative hepatitis B virus (HBV)‑DNA‑PCR without treatment]. Group II included naive low viremic patients (those with HBV‑DNA‑PCR 2000 IU/ml without treatment). Group III included treatment‑experienced aviremic patients (those with negative HBV‑DNA‑PCR after 6 months of nucleotide analog treatment). All patients were checked for alanine aminotransferase (ALT), qHBsAg, and HBV‑DNA‑PCR at a regular intervals: at baseline (W0), week 12 (W12), and week 24 (w24). Results A total of 90 patients were enrolled, with 30 patients in each group. In group I, qHBsAg and ALT levels exhibited relatively stable detectable positively correlated levels from W0 to W24. In group II, qHBsAg and ALT levels were the same as group I. In group III, qHBsAg, ALT levels, and HBV‑DNA exhibited a significant decrease during the follow‑up with the use of nucleotide analog therapy. Conclusion qHBsAg measurement, which is a cheap and easy test, can replace HBV‑DNA and may help in reflection of disease activity and assessment of follow‑up.