HbsAg seviyesinin HBV DNA ve karaciğer fibrozisi ile ilişkisi

Giriş ve Amaç: Kovalent olarak kapalı dairesel DNA düzeyinin kronik hepatit B hastalarında hastalığın aktivitesini öngörmede klinik önemi bulunmaktadır. Kovalent olarak kapalı dairesel DNA düzeyinin dolaylı bir göstergesi olan hepatit B yüzey antijeni düzeyi, kronik hepatit B hastalarının yönetiminde hepatit B virüs-DNA düzeyi ile birlikte önemli rol alabilir. Çalışmamızda, hepatit B nedeni ile karaciğer biyopsisi yapılan hastaların fibrozis skorları, hepatit B virüs-DNA ve hepatit B yüzey antijeni seviyelerinin hepatit B zarf antijeni durumu dikkate alınarak kıyaslanması amaçlandı. Gereç ve Yöntem: 2017-2020 yılları arasında kronik hepatit B nedeni ile karaciğer biyopsisi yapılan hastaların biyopsi sonuçları, retrospektif kesitsel olarak değerlendirildi. Biyopsi sonucunda fibrozis değerleri hepatit B zarf antijeni durumu göz önüne alınarak değerlendirildi. Bulgular: Çalışma grubunu 71 (%55.4) erkek, 57 (%44.5) kadın toplam 128 hasta oluşturdu. Ortalama yaş erkeklerde 41.58 ± 14.27, kadınlarda 43.63 ± 12.13 idi (p: 0.38). Hepatit B zarf antijeni pozitif hastalarda hepatit B yüzey antijeninin hepatit B virüs-DNA (p: <0.01, r: 0.46), nekroinflamatuvar aktivite (p: 0.03, r: -0.38) ve fibrozis (p: <0.01, r: -0.73) ile korele olduğu görüldü. Hepatit B zarf antijeni negatif hastalarda hepatit B yüzey antijen seviyesi fibrozis ile ilişkili olarak saptanmadı. Ancak ileri fibrozisi olan hastalarda hafif fibrozisi olanlara göre hepatit B virüs-DNA anlamlı olarak yüksek (p: <0.01) beraberinde hepatit B yüzey antijeni seviyeleri ise anlamlı olarak daha düşük saptandı (p: <0.01). Sonuç: Hepatit B yüzey antijeni seviyeleri hepatit B zarf antijeni pozitif hastalarda fibrozisi ön görmede faydalı olmakla birlikte hepatit B yüzey antijeni negatif hastalarda fibrozisi öngörmede başarısı hepatit B zarf antijeni pozitif hastalar kadar iyi saptanmamıştır.

Anahtar Kelimeler:

Hepatit B, fibrozis, HbsAg seviyesi

The relationship of HbsAg level with HBV DNA and liver fibrosis

Backgorund and Aims: The level of covalently closed circular DNA has clinical significance in predicting the activity of the disease in patients with chronic hepatitis B. Hepatitis B surface antigen level, which is an indirect indicator of covalently closed circular DNA level, may play an important role together with hepatitis B virus-DNA level in the management of chronic hepatitis B patients. In this study, it was aimed to compare the fibrosis scores, hepatitis B virus-DNA and hepatitis B surface antigen titers of the patients who underwent liver biopsy due to hepatitis B, taking into account the hepatitis B e-antigen status. Materials and Method: Biopsy results of patients who underwent liver biopsy for chronic hepatitis B between 2017-2020 were evaluated retrospectively, cross-sectionally. Fibrosis values in biopsy results were evaluated considering Hepatitis B e-antigen status. Results: The study group consisted of 128 patients, 71 (55.4%) male and 57 (44.5%) female. The mean age was 41.58 ± 14.27 in men and 43.63 ± 12.13 in women (p: 0.38). In hepatitis B e-antigen positive patients, hepatitis B surface antigen was found to be correlated with hepatitis B virus-DNA (p: < 0.01, r: 0.46), necroinflammatory activity (p: 0.03, r: -0.38) and fibrosis (p: < 0.01, r: -0.73). In hepatitis B e-antigen negative patients, hepatitis B surface antigen was not found to be associated with fibrosis. However, patients with advanced fibrosis had significantly higher hepatitis B virus-DNA (p: < 0.01) and hepatitis B surface antigen titers were significantly lower (p: < 0.01) compared to patients with mild fibrosis. Conclusion: Although hepatitis B surface antigen titers are useful in predicting fibrosis in hepatitis B e-antigen positive patients, its success in predicting fibrosis in hepatitis B surface antigen negative patients was not as good as in hepatitis B e-antigen positive patients.

Keywords:

Hepatitis B, fibrosis, HbsAg,

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