Correlation of Quantitative Assay of HBsAg and Hepatitis B Virus DNA Levels Among Chronic HBV Patients Attending Pathologist Lancet Laboratory in Nairobi, Kenya

Background: Hepatitis B Virus (HBV) viral load measurements is recommended for diagnosis and monitoring of patients on treatment for Chronic Hepatitis B (CHB). However, these diagnostic techniques are molecular-based and expensive and unavailable to majority of the Kenyan population. Quantitation of hepatitis B surface antigen (HBsAg) by automated chemiluminescent micro-particle immunoassay has been proposed as a surrogate marker. Objectives: This study showed the correlation between HBsAg and HBV DNA levels among patients with CHB attending a referral Laboratory in Nairobi, Kenya. Methods: One hundred and seventy-three (173) patients were enrolled while excluding Hepatitis C Virus (HCV) and Hepatitis D Virus (HDV) positive patients. Results: The mean age of the study patients was 37.2 years, 112 (64.7%) were male, and 142 (82.1%) were hepatitis B e antigen (HBeAg) negative while 31/173 (17.9%) were HBeAg positive. The mean HBV DNA level was 2.89 log10 IU/mL and 41 (23.7%) had a baseline HBV DNA level of > 2000 IU/mL. By Mann-Whitney test, HBV DNA levels differed significantly between HBeAg positive and negative patients (P = 0.001), as did HBsAg titer (P = 0.032). Unfortunately, according to the Spearman test, there was a weak correlation between HBsAg and HBV DNA levels (P = 0.024 and r = 0.171). Conclusions: Patients with HBeAg negative test results had lower levels of HBsAg and lower levels of HBV DNA. Serum quantitation of HBsAg may not replace serum HBV DNA levels among patients with CHB in Nairobi Kenya.