Welcome to visit Journal of Microbes and Infections,
Original Article

Performance evaluation of serum ALT in tandem with HBsAg and in tandem with HBV DNA in identifying HBeAg-positive chronic non-aggressive hepatitis

  • HUANG Dan1 ,
  • LU Wei1 ,
  • ZHANG Zhanqing1 ,
  • LI Haicong2 ,
  • ZHU Zhaoqin2
Expand
  • 1. Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China; 2. Department of Medical Laboratory, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China

Received date: 2023-09-25

  Online published: 2024-02-25

Abstract

Hepatitis B e antigen (HBeAg)-positive chronic hepatitis B virus (HBV) infection undergoes two phases in sequence, termed non-aggressive hepatitis (NAH) and aggressive hepatitis (AH), respectively. But there is still a lack of perfect standard for defining HBeAg-positive NAH and AH. In this study, based on a long-term follow-up cohort of 179 patients, the functional cutoffs for alanine transaminase (ALT), hepatitis B surface antigen (HBsAg) and HBV DNA in identifying HBeAg-positive NAH were designated using Kaplan-Meier survival analysis with spontaneous HBeAg seroconversion as the endpoint event; On this basis, the performance of ALT in tandem with HBsAg and in tandem with HBV DNA in identifying HBeAg-positive NAH was evaluated. The results showed that, ALT≤60 IU/L, HBsAg >4.602 log10 IU/mL and HBV DNA >7.477 log10 IU/mL were the functional cutoffs in identifying HBeAg-positive NAH. Based on the functional cutoffs, among patients with ALT in tandem with HBsAg, the proportion of patients with pathological grade≤G1 and “grade≤G1 and stage≤S2” were both 100%, and with pathological stage≤S1 and “grade≤G2 and stage≤S1” were both 68.2%; among patients with ALT in tandem with HBV DNA, the proportion of patients with pathological grade≤G1 and “grade≤G1 and stage≤S2” were both 86.2%, and with pathological stage≤S1 and “grade≤G2 and stage≤S1” were both 69.0%; the positive likelihood ratios of ALT in tandem with HBsAg in identifying pathological grade≤G1 and “grade≤G1 and stage≤S2” were both +∞, and in identifying pathological stage≤S1 and “grade≤G2 and stage≤S1” were both 2.034; the positive likelihood ratios of ALT in tandem with HBV DNA in identifying pathological grade≤G1 and “grade≤G1 and stage≤S2” were 3.000 and 3.068, respectively, and in identifying pathological stage≤S1 and “grade≤G2 and stage≤S1” were both 2.106. The results suggested that, both ALT in tandem with HBsAg and in tandem with HBV DNA can effectively identify HBeAg-positive NAH. The performance of ALT in tandem with HBsAg in identifying HBeAg-positive NAH is better than that of ALT in tandem with HBV DNA.

Cite this article

HUANG Dan1 , LU Wei1 , ZHANG Zhanqing1 , LI Haicong2 , ZHU Zhaoqin2 . Performance evaluation of serum ALT in tandem with HBsAg and in tandem with HBV DNA in identifying HBeAg-positive chronic non-aggressive hepatitis[J]. Journal of Microbes and Infections, 2024 , 19(1) : 12 -26 . DOI: 10.3969/j.issn.1673-6184.2024.01.002

Outlines

/