Anti- hepatitis b virus surface antigen antibody. diagnostic value on significant liver fibrosis

Abstract

Introduction: the early non-invasive identification of significant liver fibrosis remains a scientific and clinical challenge. One question is the discriminating capacity of the antibody against the Hepatitis B surface antigen on significant liver fibrosis in patients with chronic hepatitis B virus infection. Objectives: to evaluate the diagnostic and predictive value of surface antigen antibody on significant liver fibrosis in chronic hepatitis B virus infection. Methodology: An observational and cross-sectional study was conducted including fifteen patients infested chronically with hepatitis B virus with significant liver fibrosis and forty-three control subjects without significant liver fibrosis. Platelet count, antibody levels versus surface antigen, surface antigen, aspartate-aminotransferase, and alanine-aminotransferase were measured by automated methods, according to the manufacturer's instructions. The APRI and FIB-4 liver fibrosis indices were calculated according to the recommended formula. Significant liver fibrosis was considered when the FIB-4 and/or APRI indices were equal to or greater than 1.45 and 0.5, respectively. The SPSS statistical package, version 18.0, was used to analyze the results. Results: serum levels of antibody against surface antigen were found as an independent predictor (multiple regression; OR= 0.680; p= 0.021) and good discriminant (AUROC=0.876; p=0.000) of significant liver fibrosis. The cut-off points of 4.9 mIU/ml for this antibody showed 100% and 72.1% sensitivity and diagnostic specificity, respectively, and positive likelihood ratio of 3.58. Conclusions:  the serum level of the antibody against the surface antigen showed diagnostic capacity and predictive value on the significant ongoing liver fibrosis of chronic hepatitis B virus infection. Serum levels of surface antigen less than 4.9 mIU/ml suggest significant liver fibrosis during chronic hepatitis B virus infection. The cut-off points 4.25 mIU/ml showed the highest percentage of diagnostic accuracy (88%).