Abstract:

Objective The quantitative level of serum hepatitis B surface antigen（qHBsAg）has been evaluated as a marker of liver histological fibrosis in the chronic hepatitis B patient group. However ，few study focuses on HBeAg ⁃negative chronic HBV patients. The purpose of this study is to assess whether the quantitative level of qHBsAg has diagnostic value in staging of liver fibrosis in untreated HBeAg⁃negative chronic HBV patients. Methods The relationships between the quantitative levels of HBsAg and HBV DNA，alanine aminotransferase （ALT），aspartate aminotransferase（AST），liver fibrosis and other indicators were retrospectively analyzed. The HBsAg levels were measured at baseline as a single point of quantification and the cut⁃off point for the evaluated qHBsAg was 1 000 IU/mL. It was used to prove whether it could distinguish patients with mild fibrosis（S0⁃1）from significant fibrosis（S2⁃4）. Results Compared with patients with qHBsAg level < 1 000 IU/mL，patients with qHBsAg level > 1 000 IU/mL are more likely to develop S2⁃4 fibrosis（P = 0.029）and the difference is statistically significant. However，there was no significant difference in qHBsAg in patients with S0⁃1（3.53 ± 0.15）and S2⁃4 fibrosis（3.62 ± 0.16，P = 0.07）in different fibrosis stages. When HBV DNA（> 2 000 IU/mL）combined with HBsAg cut⁃off valueto evaluate different liver fibrosis stages，the incidence of significant fibrosis（S2⁃4）has no obvious correlation with qHBsAg level. qHBsAg could not accurately identify the stage of fibrosis（AUROC，0.62， cut ⁃ off value of 3 758 IU/mL，sensitivity of 73.1% ，specificity of 54.2%）. Conclusion Serum HBsAg levels could not distinguish patients with significant fibrosis（S2⁃4）. In addition，more than half of patients with no signif⁃ 

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