The role of quantitative HBsAg in the natural history of e antigen-negative chronic hepatitis B: A Tunisian prospective study

• Published in: Infectious diseases now (Online) 2021-08, Vol.51 (5), p.464-469
• Main Authors: Baklouti, Raoua, Gueddiche, Arwa, Ben Abdelwahed, Mehdi, Aissaoui, Firas, Zakhama, Majda, Bouhlel, Wided, Sriha, Asma, Kooli, Ikbel, Sallem, Om Kalthoum, Argoubi, Aida, Hichem, Loghmeri Mohamed, Ben Chaabane, Nabil, Safer, Leila
• Format: Article
• Language: English
• Subjects: Chronic hepatitis B e antigen; HBsAg; HBV; Viral load
• ISSN: 2666-9919; 2666-9919
• DOI: 10.1016/j.idnow.2020.10.004

•As vaccination against hepatitis B virus (HBV) infection progresses around the world, persons presenting with chronic HBV infection (CHI) require optimal management, which is based on virological markers such as HBe serology and HBV DNA viral load.•Over recent years, HBs antigen quantification (HBsAgQT) has appeared as a new marker helping to orient anti-HBV interferon treatment, and it is now recommended as a means of differentiating the CHI phases and optimizing the monitoring of infected patients.•In this context, our prospective study on HBsAgQT in HBe Ag negative CHI Tunisian patients helps to determine the optimal threshold of this marker for optimal follow-up of largely predominant CHI patients.•The identified decision threshold is consistent with those found in recent studies on similar patients from other geographical areas. During the natural course of Chronic Hepatitis B (CHB) infection, differentiation between inactive carrier (IC) and HBeAg negative CHB is a subject of ongoing debate. We studied the role of hepatitis B surface antigen (HBsAg) level as a means of differentiating between CHB and IC in a group of untreated chronic HBeAg-negative HBV-infected patients. A total of 115 HBeAg negative carriers were enrolled and followed up for>12 months; 78 as inactive carriers (IC), and 37 as active carriers (AC). Among ACs, patients were categorized according to the highest rate of viral load: AC1 (n=23), active carriers with persistent HBV-DNA20,000 IU/mL. HBsAg levels were higher in AC compared to IC patients (1607 IU/ml vs. 225 IU/ml respectively, P=0.001). Among the AC group, the 23 AC1 cases had HBsAg levels significantly lower than the 14 AC2 patients (1756 IU/mL vs. 3327 IU/mL respectively; P