htp://saliniana.com.ba 11 ACTA MEDICA SALINIANA © 2019 by Acta Medica Saliniana ISSN 0350-364X DOI: 10.5457/517 Marija Dimzova Mile Bosilkovski Magdalena Gasheva Boban Toshevski Biljana Petreska Marija Cvetkova Dejan Jakimovski Afliation: University Clinic for Infectious Diseases and Febrile Conditions, Medical Faculty, University Ss. Cyril and Methodius”, Skopje, Republic of North Macedonia Corresponding author: Marija Dimzova Email: marijadimzova@hotmail.com CONFERENCE PAPER THE CLINICAL SIGNIFICANCE OF QUANTITATIVE HBSAG IN PATIENTS WITH HBEAG NEGATIVE CHRONIC HEPATITIS B Marija Dimzova, Mile Bosilkovski, Magdalena Gasheva, Boban Toshevski, Biljana Petreska, Marija Cvetkova, Dejan Jakimovski ABSTRACT Background: The quantifcation of HBsAg provides diferent and complementary information that helps in determination of the diferent phases of chronic hepatitis B viral infection, evaluation and follow-up of liver disease progression as well as in treatment individualization. Aim: To evaluate the clinical signifcance of quantitative HBsAg (qHBsAg) in patients with HBeAg negative chronic hepatitis (CHB) and its correlation with the serum levels of alanine aminotransferase (ALT), quantitative HBV DNA and liver fbrosis. Subjects and Methods: The study included 53 treatment naïve patients with HBeAg negative chronic hepatitis B. All patients underwent complete laboratory and serology testing, quantifcation of HBV DNA and HBs antigen. The liver stifness was measured with elastography. Patients’ demographic characteristics, viral and biochemical markers were recorded at one point of time. Results: Correlation analysis between the qHBsAg and ALT showed an signifcant, positive correlation between the parameters for R=0.42 and p<0.05; there was statistically non-signifcant positive correlation for R=0.25 and p>0.05 between qHBsAg and HBV DNA. There was a positive correlation between qHBsAg and liver fbrosis for R=0.08 and p>0.05. The serum levels of HBsAg had greater impact on the serum levels of ALT compared to that of HBV DNA for R=0.15 and p>0.05. Conclusion: Patients with higher ALT values and higher liver fbrosis score have higher qHBsAg; qHBsAg can refect the serum HBV DNA levels. Key words: hepatitis B virus, HBsAg, HBeAg, quantitative HBsAg, quantitative HBV DNA INTRODUCTION Chronic hepatitis B virus (CHB) infection afects 248 to 257 million people worldwide and is associated with 1 million mortalities every year [1]. While the persistence of HBsAg for more than 6 months defnes chronic HBV state, its clearance from serum is considered the nearest-to-cure outcome of HBV infection. The process of seroconversion from HBeAg to anti-HBe is usually associated with remission of liver disease, but certain proportion of HBe negative, anti-HBe-positive patients with precore/ core promoter mutations continue to have viral replication with ongoing progression of the diseases [2]. This HBeAg-negative phase of HBV infection is heterogeneous, and encompasses a wide spectrum ranging from non-progressive inactive infection to active chronic hepatitis B infection, with high risk of liver cirrhosis and hepatocellular carcinoma (HCC)[2- 4]. The HBeAg-negative chronic hepatitis B is characterized by fuctuating levels of hepatitis B virus deoxyribonucleic acid (HBV DNA) and aminotransferases, with temporary remissions [2-5]. Usually, quantifcation of HBV DNA is widely used as an indicator of viral replication and a mandatory virology marker for a timely and appropriate initiation of antiviral therapy as well as for monitoring the antiviral response, but it is an expensive test and not always readily available [5-7]. As it is widely known, serum hepatitis B surface antigen (HBsAg) is a reliable biomarker of apparent hepatitis B virus infection. It is secreted as a subviral particles by infected cells in a larger extent than the infectious virons [2,8-10]. It has been proposed that the serum concentration of HBV surface antigen (HBsAg) refects the amount of covalently closed circular DNA (cccDNA) in the liver, where it acts as template for