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- Title
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.
- Authors
Sonneveld, Milan J; Hansen, Bettina E; Brouwer, Willem P; Chan, Henry L-Y; Piratvisuth, Teerha; Jia, Ji-Dong; Zeuzem, Stefan; Chien, Rong-Nan; Knegt, Robert J de; Wat, Cynthia; Pavlovic, Vedran; Gaggar, Anuj; Xie, Qing; Buti, Maria; Man, Robert A de; Janssen, Harry L A; Group, SONIC-B Study; Chien, R N; de Knegt, R J; de Man, R A
- Abstract
<bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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).<bold>Conclusions: </bold>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.
- Publication
Journal of Infectious Diseases, 2022, Vol 225, Issue 11, p1967
- ISSN
0022-1899
- Publication type
journal article
- DOI
10.1093/infdis/jiaa192