Study the Seroclearance of HBs Antigen in Patients with Confirmed Hepatitis B Infection During Receiving nucleotide Analougue in Comparison with No Treatment
Authors: Abdel Ghafour Mustafa Jalal Abdel Halim , Kamel Mawaddah Ammar Hatim , Obaid Anfal Salman Eidan , Hijlan Manar Mahmood Abdullaha , Abdul Randa Saadoun Batal 
Published: August 2024

Chronic HBV infection is defined as persistence of hepatitis B surface Antigen (HBSAg) for at least six months, and the testing strategy involves an initial serological test to detect HbsAg followed by HBV DNA viral load to help guide treatment decision. After recovery from acute HBV infection, the levels of HbsAg become undetectable. HbsAg concentrations differ during the varying longitudinal phases of disease and are generally higher in individuals with detectable HbeAg. With the development of novel antiviral agents to treat CHB, there has been renewed interest in using HbsAg loss as a therapeutic endpoint and predict the seroclearance. A total of 40 samples were collected from patients infected with Hbs viral infection who are outpatients to Abu Ghraib General Hospital, Baghdad and Al-Qaim General Hospital in Al-Qaim city and Fallujah Teaching hospital for maternity and children and Many private laboratories in Fallujah city from 15th October 2022 to 2nd March 2023.The included patients in this study were patients who are infected with Hepatitis B (Hbs) Virus infection from different stages of infection (especially the end stage of infection) or recovered from the infection. A questionnaire was applied during sample collection to gather the information from patients including: age, Gender, Type of drug, Stage of disease, Time from infection, HBS viral load if present, liver enzymes (ALT, AST, ALP) if present. Many of those information were excluded because of its none availability for many patients. One of the most important stages that any patient infected with HBs virus aim to reach it is the seroclearance stage when he would be eligible to practice his activities normally as a carrier for the infection. Therefore; this study aims to study the patient characteristics that might be correlate with attaining the seroclearance state including the age, gender, disease stage and specifically the type of drug. The study results showed that among 30 patients randomly selected with confirmed HBs infection recently, the number of Males (19) is higher than Females (11) and the concentration of HBs Ag is higher in the males (15.170 ± 6.51 ng/ml) than females (14.40 ± 7.66 ng/ml) with no significant differences calculated statistically (P value > 0.05). The mean of ages in our study was 41.8 ± 13.4 years and the percentage of ages higher than 35 years (30%) was lower than younger patients under 35 years (70%) indicating that most of infected people were younger age groups from our population. The concentrations of HBs Ag in the patients older than 35 years were lower significantly (15.0 ± 6.9 ng/ml; P value = 0.02) than the patients younger than 35 years (15.5 ± 6.9 ng/ml) without presence of significant correlation between ages and gender (P value = 0.282). Most of the patients that included in our study were patients with end or advanced stage of infection who may receive drug for treatment of not (93.3 %) with a mean (14.95142857 ± 6.896200152 ng/ml) compared with those who were in the initial stages of therapy who represent a low percentage of our study group (6.6 %) with a mean (19.125 ± 0.005 ng/ml). Most of the patients who were in the end stage of infection were in the age group older than 35 years ( 20) and lesser numbers exist in the age group younger than 35 years (8).Only 4 patients in our study showed undetectable concentrations of HBs Ag while the highest number (significantly with a P value = 0.03) of the patients showed positive results ranging from (8.08 ng/ml to 20.47 ng/ml) with a mean equal to 17.57 ± 3.4 ng/ml. The highest number of patients in our study did not receive any type of treatment during the period of sample collection (with no confirmation if they receive any drug recently or not) were 13 patients followed by Tenofovir and Entecavir (7 and 6 sequentially) and the least number were patients who receive adefovir (3 patients) followed by lamivudine (1 patient only).