Can quantitative surface antigen levels and systemic immune-inflammation index be predictive as a new indicator for the initiation of treatment in chronic hepatitis b?

OBJECTIVES: The natural history of chronic HBV infection (CHB) is generally divided into four phases: HBeAg-positive chronic HBV infection (EPCI) and -hepatitis (EPCH), HBeAg-negative chronic HBV infection (ENCI) and -hepatitis (ENCH). This study aimed to investigate changes in serum quantitative surface antigen (qHBsAg), systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI) in a large number of CHB patients. METHOD: Three hundred seventy-two CHB patients who underwent liver biopsy between January 2015 and February 2020 were evaluated. RESULTS: The SII-values were strongly significant between EPCI-EPCH ( P = 0.002), however, there was significant difference between ENCI-ENCH ( P = 0.025). Considering the SIRI results, there was a significant difference between both EPCI-EPCH ( P = 0.009) and ENCI-ENCH ( P = 0.118). In HBeAg-positive patients HBV-DNA, qHBsAg, and SII were found to be predictive ( P = 0.029, P = 0.039, P = 0.027, respectively) while in HBeAg-negative patients, age, AST, HBV-DNA, qHBsAg, SII, and SIRI were found to be predictive ( P = 0.047, P = 0.084, P = <0.001, P = 0.001, P = 0.012, P = 0.002, respectively). In EPCH phase, whereby accuracy rate results of HBV-DNA, qHBsAg, and SII were 75.3%, 73.4%, and 60.4%, respectively, while in the ENCH phase the accuracy rates of age, AST, HBV-DNA, qHBsAg, SII, and SIRI values were 57.8%, 65.6%, 68.3%, 63.8%, 57.3% and 53.2%, respectively. CONCLUSION: HBV-DNA, qHBsAg, and SII are predictive in EPCH patients. Age, AST, HBV-DNA, qHBsAg, SII and SIRI are all predictive in ENCH patients. In patients with CHB, we recommend using SII to distinguish between EPCI-EPCH and ENCI-ENCH. Based on its sensitivity and features, we believe that qHBsAg and SII are suitable measuring instruments in discrimination both of EPCI-EPCH and ENCI-ENCH.

Visceral Adiposity Index As a Practical Tool in Patients with Biopsy-Proven Nonalcoholic Fatty Liver Disease/Nonalcoholic Steatohepatitis.

Aim: Our study aimed to examine the relationship of the visceral adiposity index (VAI) with clinical and histological parameters in biopsy-proven nonalcoholic fatty liver disease (NAFLD) cases and evaluate its place in clinical practice. Materials and Methods: The study included 57 biopsy-proven NAFLD cases and 57 healthy controls. The VAI values of the cases were calculated with the formula based on body mass index, waist circumference, triglycerides, and high-density lipoprotein cholesterol levels. The relationships between VAI values and clinical and histological parameters were examined. Results: While the VAI was significantly higher in the NAFLD cases in comparison to the control group (3.5 ± 3.09 vs. 1.60 ± 0.98, respectively, P < 0.001), this difference was more noticeable in the nonalcoholic steatohepatitis (NASH) group (3.60 ± 3.35) (P < 0.001). In distinguishing the NAFLD group and the healthy group in VAI, it was determined that VAI had a sensitivity of 72%, specificity of 68%, and an area under the receiver operating characteristic curve value of 76.9%. No significant relationship was found between the histological parameters and VAI scores. Conclusions: Our study showed that VAI was increased in the NAFLD cases. This increase was observed to be more noticeable in especially the NASH cases. It is possible for this index to be a practical modality that could be used in clinical practice in prediction of especially NASH cases, which constitute the progressive form of the disease, but in this sense, there is a need for further studies.