Evaluation of Clinical and Laboratory Findings in HBsAg Positive Patients: A Comprehensive Retrospective Study

Bulgularının Değerlendirilmesi: Kapsamlı Retrospektif Bir ÇalışmaBackground: Hepatitis B virus (HBV) infection remains a major global health concern.This study aimed to evaluate the clinical and laboratory characteristics of patients with positive hepatitis B surface antigen (HBsAg) results and to provide real-world insights into HBV detection, serological profiles, and clinical management. Materials and Methods: This retrospective study included patients with positive HBsAg results between August 2023 and May 2025.Data on indications for testing, requesting departments, accompanying serological markers, current antiviral regimens, and previous treatment modifications were obtained from hospital records.HBsAg-positive patients were compared according to anti-HBs status.Patients receiving antiviral therapy were also evaluated with respect to their history of modifications to previously used nucleos(t) ide analogues.Results: A total of 295 patients were included.The most common reason for HBsAg testing was routine chronic hepatitis B followup (52.2%), followed by preoperative or screening evaluations (32.2%).Concurrent HBsAg and anti-HBs positivity was detected in 5.9% of tested patients and was associated with significantly lower HBsAg cut-off index values (p < 0.001).Among the 64 patients receiving antiviral therapy on the index date, 19 (29.7%) had a history of modification to a previously used antiviral agent.Tenofovir disoproxil fumarate was the most frequently modified of the previously used agents, and the documented reasons for these modifications were predominantly renal-and bone-related conditions.No modification involving the discontinuation of previously used tenofovir alafenamide fumarate was documented.A history of treatment modification was associated with a longer total duration of antiviral treatment (p = 0.004). Conclusion:The findings provide an integrated perspective on the circumstances of HBsAg detection, atypical serological profiles, and antiviral treatment histories.They support appropriate evaluation following HBsAg detection, the individualized selection of antivirals, and careful long-term monitoring.Keywords: Hepatitis B, HBsAg, anti-HBs, chronic hepatitis B, tenofovir, serological markers Amaç: Hepatit B virüsü (HBV) enfeksiyonu küresel ölçekte önemli bir halk sağlığı sorunu olmaya devam etmektedir.Bu çalışmada HBsAg pozitifliği saptanan hastaların klinik ve laboratuvar özelliklerinin değerlendirilmesi ve HBV'nin saptanma koşulları, serolojik profiller ve tedavi yönetimine ilişkin gerçek yaşam verilerinin sunulması amaçlanmıştır.Gereç ve Yöntemler: Bu retrospektif çalışmaya Ağustos 2023 ile Mayıs 2025 tarihleri arasında HBsAg pozitifliği saptanan hastalar dahil edildi.Test istem endikasyonları, istem yapan klinikler, eşlik eden serolojik belirteçler, mevcut antiviral tedaviler ve geçmiş tedavi değişikliklerine ilişkin veriler hastane kayıtlarından elde edildi.HBsAg pozitif hastalar anti-HBs durumuna göre karşılaştırıldı.Antiviral tedavi alan hastalar ayrıca daha önce kullanılan nükleoz(t)id analoglarında değişiklik yapılma öyküsüne göre değerlendirildi.Bulgular: Toplam 295 hasta çalışmaya dahil edildi.HBsAg testinin en sık istem nedeni kronik hepatit B'nin rutin takibi (%52,2) olup bunu preoperatif değerlendirme veya tarama amaçlı istemler (%32,2) izledi.