The relationship between collagen proportionate area and Hepatitis B surface antigen levels in e antigen positive hepatitis B cirrhosis

Background: Quantitative serum HBsAg has been widely used as a biomarker for treatment response and prognosis in chronic hepatitis B, and recently been found associated with liver histology in HBeAg positive patients. Collagen proportionate area (CPA) as a continuous variable is a appropriate histological measurement to assess the degree of fibrosis and substages cirrhosis. We aimed to explore the association of serum HBsAg level with CPA in e antigen positive hepatitis B cirrhosis.Methods: Liver fibrosis staging was evaluated semiquantitatively according to the Metavir scoring system, only patients with METAVIR stage 4 were included. All liver biopsies were restained with picroSirius red for collagen quantification and determination of CPA by digital image analysis.Results: Mean collagen proportionate area value was 23.46%. The percentage of patients with different classification of CPA (< 20%, 20%-30%, >30%) were 25.8%, 57.8%, and 16.4%, respectively. A modest correlation was observed between CPA and serum HBsAg (r = -0.306, p = 0.001). HBsAg level is independently associated with collagen proportionate area in multivariable linear regression analyses.Conclusion: Serum HBsAg levels can predict liver fibrosis determined by CPA in e antigen positive hepatitis B cirrhosis.