Historic and current hepatitis B viral DNA and quantitative HBsAg level are not associated with cirrhosis in non-Asian women with chronic hepatitis B

SummaryBackgroundSome studies done in Asian patients have shown that serum levels of hepatitis B virus (HBV) DNA predict the development of cirrhosis. However, it is unclear whether this also applies for non-Asian patients. This study investigated historic and current HBV DNA and quantitative hepatitis B surface antigen (HBsAg) levels as predictors of cirrhosis in non-Asian women with chronic HBV.MethodsA retrospective cohort study of non-Asian women with chronic HBV was performed. Among other variables, HBV DNA and quantitative HBsAg levels were measured in stored historic serum samples obtained during pregnancy (period 1990–2004) and current serum samples (period 2011–2012) to determine any association with liver cirrhosis by liver stiffness measurement (LSM).ResultsOne hundred and nineteen asymptomatic, treatment-naïve non-Asian women were included; the median number of years between the historic sample and the current sample was 17 (interquartile range (IQR) 13–20). The median historic log HBV DNA and quantitative log HBsAg levels were 2.5 (IQR 1.9–3.4) IU/ml and 4.2 (IQR 3.6–4.5) IU/ml, respectively. LSM diagnosed 14 patients (12%) with F3–F4 fibrosis, i.e. stiffness >8.1 kPa. No association of cirrhosis was found with historic HBV DNA (relative risk (RR) 0.34, 95% confidence interval (CI) 0.05–2.44) or with the quantitative HBsAg level (HBsAg level >1000 IU/ml, RR 0.35, 95% CI 0.11–1.11). Multivariable analysis identified alcohol consumption (odds ratio (OR) 6.4, 95% CI 1.3–30.1), aspartate aminotransferase >0.5 times the upper limit of normal (OR 15.4, 95% CI 1.9–122.6), and prothrombin time (OR 12.0, 95% CI 1.2–120.4), but not HBV DNA or quantitative HBsAg level, to be independent predictors of the presence of cirrhosis.ConclusionsNeither historic nor current HBV DNA or the quantitative HBsAg level is associated with the development of HBV-related cirrhosis in non-Asian women.