Table 2.
Clinical importance of hepatitis B surface antigen quantification in hepatitis B surface antigen negative patients in either predicting hepatitis B surface antigen seroclearance or differentiating inactive carriers from chronic hepatitis patients
Ref. |
Studies predicting HBsAg seroclearance |
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Study design | HBsAg levels | Reliability of prediction | |
Chan et al[68] | Genotype B/C, longitudinal study for 11 yr | HBsAg < 100 IU/mL | 75% sensitivity and 91% specificity |
Chan et al[85] | Longitudinal study for 99 ± 16 mo | HBsAg levels < 1000 IU/mL and HBV DNA < 2000 IU/mL | Cumulative probability of 9% and 21% at 5 and 8 yr respectively |
Tseng et al[86] | Follow-up at 1 yr after spontaneous HBeAg seroclearance | HBsAg < 100 IU/mL vs 100-999 IU/mL | Hazard ratio 24.3 vs 4.4 for HBsAg seroclearance |
Tseng et al[87] | Genotype B/C follow-up of 11.6 yr | HBV DNA < 2000 IU/mL and HBsAg < 10 IU/mL | Adjusted hazard ratio of HBsAg loss was 13.2 |
Martinot-Peignoux et al[70] | Follow-up of 1 yr | HBsAg < 1000 IU/mL, annual decrease > 0.3 log IU/mL | 95%NPV and 89% PPV |
Differentiation of inactive disease from chronic hepatitis | |||
Brunetto et al[69] | Genotype D, Follow-up for 34.5 mo | HBsAg levels < 1000 IU/mL and HBV DNA < 2000 IU/mL | 88% NPV and 97% PPV to identify inactive carriers |
Martinot-Peignoux et al[70] | Follow-up of 1 yr | HBsAg levels > 1000 IU/mL and HBV DNA > 200 IU/mL | 96% NPV and 92% sensitivity to identify reactivation |
Larsson et al[88] | Single time point evaluation of ALT, histological score | HBsAg levels < 1000 IU/mL and HBV DNA < 10000 IU/mL | 96% PV to identify inactive carriers |
Park et al[89] | Genotype C follow-up > 48 mo | HBsAg levels > 850 IU/mL and HBV DNA > 850 IU/mL | 85% diagnostic accuracy to identify reactivation |
HBV: Hepatitis B virus; NPV: Negative predictive value; HBsAg: Hepatitis B surface antigen; PPV: Positive predictive value.