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Age and platelet count have been reported as independent factors associated with HBsAg titer [Jaroszewicz et al., 2010]. However, these findings were not reproduced in the subgroup analysis for each phase in this study. HBsAg titer was associated negatively with age only in the phases with low immune activity (immune tolerance and low replicative phases) and was associated positively with platelet count only in the immune clearance and low replicative phases. Because the dynamic progression of the natural history of HBV infection generally accompanies aging, the association between age and HBsAg titer is not surprising. A previous report found that platelets could mediate cytotoxic T lymphocyte in liver damage, and it could be inferred that the immunologic role of platelets may influence HBsAg titer. In the present study, the HBsAg/platelet ratios used to evaluate selleck chemicals llc the impact Quetiapine of platelet count on HBsAg were 2.83?��?0.48, 2.42?��?0.51, 1.45?��?0.78, and 1.99?��?0.42 in the immune tolerance, immune clearance, low replicative, and HBeAg-negative hepatitis phases, respectively. In the low replicative phase, HBsAg/platelet ratios were more strongly suppressed in contrast with the HBsAg/HBV DNA ratio. This suggests that the positive correlation between platelets and secretion of subviral particles is weakened in situations of profound dissociation of the production mechanism for subviral particles and HBV replication. These results suggest that physicians should consider the effect of platelet count in interpreting the clinical meaning of HBsAg titer when monitoring patients infected with HBV, especially in patients in the immune clearance and low replicative phases of genotype C HBV. In conclusion, HBsAg titers showed significant differences according to the natural phases of HBV infection, and HBsAg titer was independently correlated with HBV DNA titer. Hence, HBsAg titer may LDK378 molecular weight be a complementary biomarker and measurement of HBsAg titer could be used as a monitoring method for patients infected with HBV. The HBsAg titer of patients infected with genotype C HBV showed some differences compared with previous reports of other genotypes. Further large, longitudinal follow-up studies including diverse major genotypes of HBV are needed to determine the role of HBsAg titer and its clinical significance. The authors acknowledge and are thankful for the contributions of other collaborators in the Korea University College of Medicine (Eileen L. Yoon, Hyun Jung Lee, Soon Jae Lee, Hae Rim Kim, Seong Hee Kang, Beom Jae Lee, Yeon Seok Seo, Hyung Joon Yim, Jong-Jae Park, Jae Seon Kim, Young Tae Bak, Soon Ho Um, Ho Sang Ryu). Additional supporting information may be found in the online version of this article at the publisher's web-site. ""Joint tissues are exquisitely sensitive to their mechanical environment.
