Usefulness of quantitative hepatitis B surface antigen testing in hepatitis B community-based screening.


Journal

Journal of the Formosan Medical Association = Taiwan yi zhi
ISSN: 0929-6646
Titre abrégé: J Formos Med Assoc
Pays: Singapore
ID NLM: 9214933

Informations de publication

Date de publication:
Feb 2021
Historique:
received: 03 06 2020
revised: 15 08 2020
accepted: 21 08 2020
pubmed: 9 9 2020
medline: 3 3 2021
entrez: 8 9 2020
Statut: ppublish

Résumé

Low viral load (LVL) of hepatitis B virus (HBV) is a predictor of chronic HBV infection. However, the usefulness of quantitative hepatitis B surface antigen (qHBsAg) in predicting LVL in community-based screening has not been well studied. We aimed to measure the prevalence of LVL in HBV carriers and validate the efficacy of qHBsAg in predicting LVL. This community-based screening study was conducted in Taiwan. HBV DNA was assayed in HBsAg carriers. Participants were randomized to training and validation sets to determine the ability of qHBsAg to predict LVL. Receiver operating characteristic curves were used to identify the best cutoff values in the training set. Among the 2919 participants, 359 (12.2%) were HBsAg carriers. There were 132 and 137 carriers in the training and validation sets, respectively. Significant correlations were found between qHBsAg and HBV DNA in both training and validation sets. Thirty and 29 participants with qHBsAg <8 IU/mL in the training and validation sets, respectively, had LVL. Using 8 IU/mL as the cutoff, negative predictive value (NPV) of qHBsAg for HBV DNA levels >2000 IU/mL was 100%. The best cutoff level of qHBsAg to predict HBV LVL was 200 IU/mL, with a sensitivity, specificity, and accuracy of 75.0%, 76.1%, and 75.8%, respectively, in the training set. The positive predictive value and NPV were 70.0% and 77.9%, respectively, in the validation set. Approximately 60% of HBsAg carriers had HBV LVL, and qHBsAg <8 IU/mL accurately predicts LVL. This quantitative test provides additional information for community-based screening.

Sections du résumé

BACKGROUND/PURPOSE OBJECTIVE
Low viral load (LVL) of hepatitis B virus (HBV) is a predictor of chronic HBV infection. However, the usefulness of quantitative hepatitis B surface antigen (qHBsAg) in predicting LVL in community-based screening has not been well studied. We aimed to measure the prevalence of LVL in HBV carriers and validate the efficacy of qHBsAg in predicting LVL.
METHODS METHODS
This community-based screening study was conducted in Taiwan. HBV DNA was assayed in HBsAg carriers. Participants were randomized to training and validation sets to determine the ability of qHBsAg to predict LVL. Receiver operating characteristic curves were used to identify the best cutoff values in the training set.
RESULTS RESULTS
Among the 2919 participants, 359 (12.2%) were HBsAg carriers. There were 132 and 137 carriers in the training and validation sets, respectively. Significant correlations were found between qHBsAg and HBV DNA in both training and validation sets. Thirty and 29 participants with qHBsAg <8 IU/mL in the training and validation sets, respectively, had LVL. Using 8 IU/mL as the cutoff, negative predictive value (NPV) of qHBsAg for HBV DNA levels >2000 IU/mL was 100%. The best cutoff level of qHBsAg to predict HBV LVL was 200 IU/mL, with a sensitivity, specificity, and accuracy of 75.0%, 76.1%, and 75.8%, respectively, in the training set. The positive predictive value and NPV were 70.0% and 77.9%, respectively, in the validation set.
CONCLUSION CONCLUSIONS
Approximately 60% of HBsAg carriers had HBV LVL, and qHBsAg <8 IU/mL accurately predicts LVL. This quantitative test provides additional information for community-based screening.

Identifiants

pubmed: 32896456
pii: S0929-6646(20)30405-8
doi: 10.1016/j.jfma.2020.08.031
pii:
doi:

Substances chimiques

DNA, Viral 0
Hepatitis B Surface Antigens 0
Hepatitis B e Antigens 0

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

847-853

Informations de copyright

Copyright © 2020 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest All authors declare no conflicts of interest.

Auteurs

Kao-Chi Chang (KC)

Division of Hepatology and Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.

Chih-Yi Lee (CY)

Department of Laboratory Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.

Te-Sheng Chang (TS)

Division of Hepatology and Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan; Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Yunlin, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.

Chao-Hung Hung (CH)

Department of Internal Medicine, Division of Hepato-Gastroenterology, Kaohsiung Chang Gung Memorial Hospital, Taiwan.

Wei-Ming Chen (WM)

Division of Hepatology and Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.

Mei-Yen Chen (MY)

College of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan.

Tung-Jung Huang (TJ)

Division of Thoracic Medicine, Chang Gung Memorial Hospital, Yunlin, Taiwan.

Wen-Nan Chiu (WN)

Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Yunlin, Taiwan.

Jing-Hong Hu (JH)

Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Yunlin, Taiwan.

Yu-Chih Lin (YC)

Division of Family Medicine, Chang Gung Memorial Hospital, Yunlin, Taiwan.

Wei-Cheng Huang (WC)

Department of Geriatric, Chang Gung Memorial Hospital, Chiayi, Taiwan.

Nien-Tzu Hsu (NT)

Biostatistics and Bioinformatics Center of Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.

Sheng-Nan Lu (SN)

Department of Internal Medicine, Division of Hepato-Gastroenterology, Kaohsiung Chang Gung Memorial Hospital, Taiwan; Biostatistics and Bioinformatics Center of Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan. Electronic address: juten@ms17.hinet.net.

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