Can HBsAg Be Used as a Viral Replication Marker in Chronic Hepatitis B Patients?

Objective: Monitoring hepatitis B virus (HBV) treatment responses and virus replication is performed with molecular tests. However, these tests are either expensive or invasive. A new and more practical marker is needed. We aimed to evaluate the correlation between serum hepatitis B surface antigen (HBsAg) and alanine aminotransferase (ALT) levels and HBV DNA level in hepatitis B e antigen (HBeAg) +/- patients and detect whether HBsAg can be used as a surrogate replication marker instead of HBV DNA.\udMaterial and Methods: A retrospective study was conducted in 59 chronic hepatitis B patients. Serum ALT, HBsAg and HBeAg levels and HBV DNA levels were recorded. The results were analysed with the Mann-Whitney U test and Spearman correlation coefficient. A p value of ≤0.05 was considered statistically significant. Sequential results were compared using Blant-Alpman plot. \udResults: The patients were grouped as HBeAg-positive (37.2%) and HBeAg-negative (62.8%). Serum ALT levels were elevated in 82% of HBeAg-positive and 70.2% of HBeAg-negative subjects. There was a statistically significant difference in HBsAg levels between the groups (p<0.05). However, there was no statistically significant difference in ALT and HBV DNA levels (p>0.05). A statistically significant negative correlation was detected between HBsAg and HBV DNA levels in HBeAg-positive patients. No correlation was found between HBsAg and HBV DNA levels in HBeAg-negative subjects (p<0.05). In both HBeAg-positive and -negative individuals, there was a positive correlation between serum ALT and HBV DNA levels (p<0.05). Blant-Alpman graph did not show an appropriate profile.\udConclusion: We found a negative correlation between HBsAg and HBV DNA levels in HBeAg-positive patients. However, this correlation is not practical in monitoring treatment response and replication