The summaries are free for public
use. The Chronic Liver Disease
Foundation will continue to add and
archive summaries of articles deemed
relevant to CLDF by the Board of
Trustees and its Advisors.
Abstract Details
Clinical utility of quantifying hepatitis B surface antigen in African patients with chronic hepatitis B
J Viral Hepat. 2021 Mar 22. doi: 10.1111/jvh.13499. Online ahead of print.
Gerrit Post1, Jess Howell2, Amina Sow3, Gibril Ndow4, Isabelle Chemin5, Gora Lo3, Amie Cessay4, Damien Cohen5, Ramou Njie6, Souleymane Toure7, Madoky Diop7, Roger Sombie8, Jean Nana9, Vincent Leroy9, Karine Lacombe10, Lamin Bojang4, Frank Tacke1, Coumba Toure-Kane3, Mourtalla Ka7, Maimuna Mendy6, Souleymane Mboup3, Mark Thursz11, Yusuke Shimakawa12, Patrick Ingiliz113, Maud Lemoine11
Author information
1Department of Gastroenterology and Hepatology, Charité University Medical Center, Berlin, Germany.
2Disease Elimination, Burnet Institute, Department of Gastroenterology, St. Vincent's Hospital Department of Epidemiology and Preventive Medicine, Monash University Melbourne, Victoria, Australia.
4Medical Research Council the Gambia unit (MRCG) @the London School of Hygiene and Tropical Medicine, Viral hepatitis Unit, Fajara, The Gambia.
5INSERM U1052, CNRS 5286, Univ Lyon, Université Claude Bernard Lyon 1, Centre Léon Bérard, Centre de Recherche en Cancérologie de Lyon, F-69000, Lyon, France.
6International Agency for Research on Cancer (IARC), Lyon, France.
7Unite de Formation et de Recherche (UFR) des sciences de la santé de l'Universite de Thies, Senegal.
8Service d'hépatogastro-entérologie, Centre Hospitalier Universitaire Yalgado Ouédraogo, Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso.
9Department of Hepatology & Gastroenterology, Université Grenoble Alpes, Grenoble, France.
10Department of infectious diseases and tropical medicine, hôpital Saint-Antoine, Sorbonne Université, Inserm IPLESP, APHP, France.
11Department of Metabolism, Digestion and Reproduction, Division of Digestive Diseases, Hepatology Section, Imperial College London, St Mary's campus, London, UK.
12Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France.
13Center for Infectiology, Berlin, Germany.
Abstract
The clinical utility of quantifying hepatitis B surface antigen (qHBsAg) levels in African subjects with chronic hepatitis B virus (HBV) infection has been poorly documented.From a multicenter cohort of 944 HBV-infected African patients we aimed to assess whether qHBsAg alone can accurately identify i) those in a HBeAg-negative chronic HBV infection phase at low risk of liver disease progression and ii) those in need of antiviral therapy according to the 2017 EASL guidelines.We analyzed 770 HBV mono-infected treatment-naïve patients, mainly males (61%) from West Africa (92%), median age 35 years (IQR: 30-44), median HBV DNA: 95.6 IU/ml (10.0-1,300.0), median qHBsAg 5,498 IU/ml (1,171-13,000), HBeAg-pos 38 (5%). A total of 464/770 (60.2%) patients were classified as HBeAg-negative chronic infection (median age 36 years (31-46), median ALT 23 IU/l (18-28), median HBV-DNA 33.5 IU/ml (3.8-154.1), median LSM 4.8 kPa (4.1-5.8)) and qHBsAg levels had poor accuracy to identify these subjects with an AUROC at 0.58 (95%CI: 0.54-0.62), sensitivity 55.0%, specificity 55.6%; 118/770 (15.3%) patients were eligible for treatment according to the 2017 EASL criteria. qHBsAg correlated poorly with HBV DNA and had poor accuracy to select patients for antiviral therapy with an AUROC at 0.54 (0.49-0.60), sensitivity 46.6%, specificity, 46.9%.In African treatment-naïve HBV-infected subjects, the clinical utility of qHBsAg to identify subjects in HBeAg-negative infection phase or subjects eligible for antiviral therapy seems futile. Whether qHBsAg levels can be used as a predictor of long-term liver complications in Africa needs to be further investigated.