الفهرس Only 14 pages are availabe for public view
 |  | from | 154 |  |  |
| | | from | 154 | | |
Abstract
BACKGROUND: chronic HBV infection is a dynamic with interchangeable different immune phases during its natural history. HBsAg levels can predict clinical, treatment outcomes and de»termine the optimal time to stop antiviral therapy. AIM: To categorize the different immune phases of chronic HBV in a cohort of Egyptian patients with special emphasis on hepatitis B e antigen negative (HBeAg-negative) phases and measure quantitative HBs Ag levels in the different immune phases. METHODS: Quantitative HBsAg level was done by Elycsys(Roche) technique in 150 patients and further validated by Architect(Abbott)technique in 92 patients. Routine biochemical, serological investigations and Transient Elastography and liver biopsy (whenever indicated) were done. RESULTS: A cohort of 150 treatment naive chronic HBV patients (males 70%, mean age 36.1 ±10.5) were enrolled, 84.6% were HBeAg-negative. Different immune phase were categorized as imunotolerant(IT) 3.3 %, immuno reactive(IR) 1.3%, inactive carriers(IC) 66% and HBeAg-ve CHB 18.7%. Across HBV immune phase, HBsAg titers were highly variable (highest levels in IT and HBeAg-ve CHB patients and least in IR and IC) with significant correlation between HBsAg titers and HBV viraemia. HBeAg-positive patients had higher HBsAg levels than HBeAg-negative patients. In HBeAg-negative CHB, HBsAg level 2638 IU/ml and HBV DNA titre <2000 IU/ml could identify inactive carriers with sensitivity 76.9%, specificity 71.9%.Both techniques for HBsAg quantification were significantly correlated to each other and could differentiate between patients with undetectable and low HBV-DNA levels(<2000IU/ml) with AUC 0.748 & 0.824 respectively