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      Validación de un inmunoensayo tipo ELISA para la cuantificación de los niveles séricos de antígeno de superficie en pacientes con infección crónica por Virus de la Hepatitis B. Translated title: Validation of an ELISA for quantitation of serum levels of surface antigen in patients with chronic hepatitis B.

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          Abstract

          Resumen Introducción Durante la etapa aguda de la infección por el Virus de la Hepatitis B (VHB) y el período inicial de una infección crónica, el DNA está en forma episomal (libre o extracromosomal) y se replica en el hepatocito produciendo, entre otros, viriones infectivos, DNA polimerasa y antígeno de superficie del virus (HBsAg). Objetivo Validar un inmunoensayo tipo ELISA para cuantificar los niveles de HBsAg en pacientes con hepatitis B crónica. Método Se realizó un estudio experimental de desarrollo tecnológico. Se llevó a cabo la normalización y validación de un inmunoensayo enzimático heterogéneo de doble anticuerpo para la cuantificación de HBsAg en sueros de seres humanos. 115 muestras de pacientes con hepatitis B crónica con resultados de carga viral se correlacionaron con las concentraciones de HBsAg. Resultados y discusión El método presentó coeficientes de variación intra e interensayo de 9,8 y 13,2% respectivamente. El rango de trabajo se estimó entre 0.15 y 60 ng/mL. El porcentaje de recuperación estuvo entre el 90 y 110% y el ajuste lineal de la curva estándar presentó un coeficiente de determinación superior a 0,99. La correlación alcanzada entre los niveles de DNA y la concentración de HBsAg fue de 62.5%. Conclusiones La evaluación del ELISA para la cuantificación de HBsAg desarrollado en el laboratorio mostró que cumple los parámetros de validación para su uso clínico.

          Translated abstract

          Abstract Introduction During the acute phase of infection with Hepatitis B Virus (HBV) and the initial period of chronic infection, DNA is episomally (free or extrachromosomal) and replicates in hepatocytes producing among other virions, DNA polymerase and virus surface antigen (HBsAg). Objective Validate an ELISA to quantify HBsAg levels in patients with chronic hepatitis B. Method An experimental study of technological developmentwas conducted. The normalization and validation of heterogeneous double antibody enzyme linked inmunoassay for quantitation of HBsAg in human sera was carried out. 115 serum samples from patients with chronic hepatitis B with viral load results were correlated with its HBsAg concentrations. Results and discussion The developed method presented variation coefficients intra and interassay of 9.8 and 13.2% respectively. The working range was estimated between 0.15 and 60 ng/mL. The recovery rate was between 90 and 110% and the linear fit of the standard curve presented a determination coefficient greater than 0, 99. The correlation between the DNA levels and HBsAg concentration was 62.5%. Conclusions The assessment of the ELISA for quantitation of HBsAg developed in the laboratory showed that it achieved validation parameters for its clinical use.

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          Hepatitis B surface antigen quantification: why and how to use it in 2011 - a core group report.

          Quantitative HBsAg had been suggested to be helpful in management of HBV, but assays were cumbersome. The recent availability of commercial quantitative assays has restarted the interest in quantitative serum hepatitis B surface antigen (HBsAg) as a biomarker for prognosis and treatment response in chronic hepatitis B. HBsAg level reflects the transcriptional activity of cccDNA rather than the absolute amount of cccDNA copies. Serum HBsAg level tends to be higher in hepatitis B e antigen (HBeAg)-positive than HBeAg-negative patients. Among patients with a low HBV DNA (<2000IU/ml), HBsAg <1000IU/ml in genotype D HBV infection and HBsAg <100IU/ml in genotype B/C HBV infection is associated with inactive carrier state in HBeAg-negative patients. The HBsAg reduction by nucleos(t)ide analogues (NA) is not as pronounced as by interferon treatment. On peginterferon treatment, sustained responders tend to show greater HBsAg decline than the non-responders. The optimal on-treatment HBsAg cutoff to predict response needs further evaluation in HBeAg-positive patients, but an absence of HBsAg decline together with a <2 log reduction in HBV DNA at week 12 can serve as stopping rule in HBeAg-negative patients with genotype D HBV infection. A rapid serum HBsAg decline during NA therapy may identify patients who will clear HBsAg in the long-term. There are early reports among Asian patients that an HBsAg level of <100IU/ml might predict lower risk of relapse after stopping NA treatment. In clinical practice, serum HBsAg level should be used together with, but not as a substitute for, HBV DNA. Copyright © 2011 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
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            Quantitative Levels of Hepatitis B Virus DNA and Surface Antigen and the Risk of Hepatocellular Carcinoma in Patients with Hepatitis B Receiving Long-Term Nucleos(t)ide Analogue Therapy

            Background: Serum levels of hepatitis B virus (HBV) DNA are an important predictor of the risk of hepatocellular carcinoma (HCC) in patients with chronic HBV infection. However, little is known about whether high levels of hepatitis B surface antigen (HBsAg) increase the risk for HCC. Methods: We investigated 167 patients who were treated with nucleos(t)ide analogues (NA) for at least 2 years (median: 5.8 years, range: 2-13.1 years). Relationships between reduced levels of HBsAg and various factors were evaluated. In addition, we evaluated the usefulness of quantitative serum levels of HBV DNA and HBsAg as predictors of HCC development in patients receiving long-term NA therapy. Results: HCC developed in 9 of the 167 NA-treated patients. In the 9 patients with HCC, HBV DNA was undetectable (<2.1 log copies/mL), but HBsAg levels were ≥2000 C.O.I. in 7 patients. No maternal transmission, long NA treatment period, HBV DNA levels <3.0 log copies/mL, and reduced hepatitis B e antigen levels during the first 24 weeks of treatment were a significant factor of HBsAg levels <2000 C.O.I.. Conclusions: Hepatocarcinogenesis was observed in patients with high HBsAg levels, despite the negative conversion of HBV DNA as a result of long-term NA therapy. Therefore, to suppress hepatocarcinogenesis, it is important to control not only HBV DNA levels but also HBsAg levels.
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              A predictive scoring system for the seroclearance of HBsAg in HBeAg-seronegative chronic hepatitis B patients with genotype B or C infection.

              Seroclearance of hepatitis B surface antigen (HBsAg) is the most ideal end point in the treatment of chronic hepatitis B. This study develops a predictive scoring system to assess whether the addition of serum levels HBsAg may improve the predictability of HBsAg loss. This study included 2491 untreated participants with genotype B or C HBV infection, who were HBsAg-seropositive, HBeAg-seronegative, anti-HCV-seronegative, and cirrhosis free at study entry. Regression coefficients of predictors in Cox Regression models were converted into integer scores for predicting HBsAg seroclearance. Predictive accuracy was assessed with area under the receiver operating characteristic curves (AUROC), and predictive accuracies of models with and without serum HBsAg levels were compared. Low serum levels of both HBsAg and HBV DNA were the strongest predictors of spontaneous HBsAg seroclearance. Compared to baseline serum HBsAg levels ≥1000 IU/ml, the multivariate adjusted rate ratio of spontaneous HBsAg seroclearance was 10.96 (7.92-15.16) for those with baseline serum HBsAg levels <100 IU/ml. The predictive ability of HBsAg levels was modified by HBV viral load, showing a weaker effect in those with higher viral loads, and the strongest effect among those with undetectable viral loads. The inclusion of serum HBsAg levels greatly improved the AUROC for predicting HBsAg seroclearance at the fifth (from 0.79 [0.787-0.792] to 0.89 [0.889-0.891]) and tenth year (from 0.73 [0.728-0.732] to 0.84 [0.839-0.841]) after study entry. Incorporated into an easy-to-use scoring system, HBV viral load and quantitative serum HBsAg levels can accurately predict HBsAg seroclearance. Copyright © 2013 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                revbiomed
                Revista biomédica
                Rev. biomédica
                Universidad Autónoma de Yucatán, Centro de Investigaciones Regionales Dr. Hideyo Noguchi Naturaleza (Mérida, Yucatán, Mexico )
                0188-493X
                2007-8447
                December 2017
                : 28
                : 3
                : 111-123
                Affiliations
                [1] orgnameCentro Nacional de Genética Médica
                [2] orgnameInstituto de Hematología e Inmunología
                Article
                S2007-84472017000300111
                10.32776/revbiomed.v28i3.549
                05151741-9b69-4960-a6a7-42c720649f7a

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 19 April 2017
                : 03 May 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 42, Pages: 13
                Product

                SciELO Mexico

                Categories
                Artículos originales

                HBV,HBsAg,ELISA,immunoassay,standardization,optimization,validation,VH,inmunoensayo,normalización,optimización,validación

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