标题: [重复新闻]CUHK - HbsAg level as marker for disease control [打印本页] 作者: StephenW 时间: 2011-10-11 07:22 标题: [重复新闻]CUHK - HbsAg level as marker for disease control
本帖最后由 风雨不动 于 2012-4-14 14:41 编辑
CUHK Discovers the Use of Hepatitis B Surface Antigen Level as a New Marker for Disease Control in Chronic Hepatitis B Patients 10/10/2011 16:41:00
Chronic hepatitis B affects about 9% of the adult population in Hong Kong, and it is the commonest cause of liver cirrhosis and liver cancer.
Nowadays, oral antiviral drugs are very effective in suppressing the replication of hepatitis B virus (HBV). However, only a small proportion of patients can clear the HBV inside the liver. After stopping the antiviral drug, most patients experience relapse of hepatitis. In other words, doctors and patients have little guidance on when to stop antiviral treatment, and most patients are put on life-long treatment. To understand the timing of stopping antiviral drug, we must be able to estimate the viral control inside the liver. Treatment can only be stopped if most of the virus inside the liver is cleared.
Hepatitis B surface antigen (HBsAg) is a unique protein produced by HBV. The detection of HBsAg indicates HBV infection. Little knowledge is known on the meaning of the level of HBsAg. In 2007, the Center for Liver Health at The Chinese University of Hong Kong (CUHK) has demonstrated a higher level of serum HBsAg reflected a higher level of HBV inside the liver. Following this finding, the researchers from the Center have conducted a series of studies to evaluate the usefulness of HBsAg level to monitor disease control in chronic hepatitis B.
The serum HBsAg level was studied in 103 chronic hepatitis B patients who have not received any antiviral treatment between 1997 and 2008. During a follow-up period up to 11 years, 12 patients had cleared HBsAg, which is an ultimate marker of immune control. A single HBsAg level of ≤100 IU/ml at the first clinic visit can predict a higher chance of HBsAg clearance. 9 of the 12 (75%) patients who had HBsAg clearance versus 8 (9%) of 91 who remained HBsAg positive had serum HBsAg ≤100 IU/ml (p<0.001). Hence, a low serum HBsAg level ≤100 IU/ml indicates a better chance of immune clearance of the virus.
As serum HBsAg level can reflect a good immune clearance of the virus, our researchers evaluated the usefulness of serum HBsAg monitoring among 53 chronic hepatitis B patients who were treated by lamivudine for an average of 3 years and followed up after treatment was stopped. 7 of the 9 (78%) of patients who achieved HBsAg of ≤100 IU/ml at the end of lamivudine treatment did not have disease relapse 1 year after stopping lamivudine, while 42 of the 44 (95%) patients who had HBsAg >100 IU/ml at the end of treatment have disease relapse (p<0.001). At 5 years after stopping lamivudine, 88% of patients who had HBsAg ≤100 IU/ml at the end of treatment remained in disease remission.
In conclusion, serum HBsAg level is a new marker to indicate viral clearance inside the liver. An HBsAg level of ≤100 IU/ml is a good indicator of viral clearance among patients with and without antiviral treatment, and it is a good predictor for disease control after stopping antiviral therapy. Therefore, CUHK recommends regular monitoring of serum HBsAg in chronic hepatitis B, particularly among patients who are on antiviral drugs to decide the timing of stopping therapy.
103慢性乙肝还没有收到任何在1997年和2008年之间的抗病毒药物治疗的患者中,血清HBsAg水平进行了研究。在长达11年的后续行动期间,12例患者清除乙肝表面抗原,这是一种免疫控制的最终标志。 ≤100 IU / ml的首诊的一个单一的HBsAg水平可以预测较高的HBsAg清除的机会。曾乙肝表面抗原清除91比8(9%)仍然HBsAg阳性12例(75%)的有9个血清HBsAg≤100 IU /毫升(P <0.001)。因此,低血清HBsAg水平≤100 IU / ml的表明了免疫清除病毒的更好的机会。
由于血清HBsAg水平可以反映一个良好的免疫清除病毒,我们的研究人员评估了53慢性乙型肝炎患者拉米夫定治疗3年的平均随访治疗停止后的有用性之间的血清HBsAg监测。 7 9(78%)患者实现表面抗原的≤100 IU /毫升拉米夫定治疗结束,没有疾病复发1拉米夫定停药后的一年,而42 44(95%)患者有乙肝表面抗原> 100国际单位/毫升,在治疗结束后疾病复发(P <0.001)。曾乙肝表面抗原在治疗结束≤100 IU / ml的患者88%在5年后停止拉米夫定,仍然在疾病的缓解期。
总之,血清HBsAg水平是一个新的标记,以表明肝脏内的病毒清除。 ≤100 IU / ml的HBsAg水平是一个很好的指标,在抗病毒治疗与不的患者的病毒清除,并停止抗病毒治疗后,疾病控制的一个很好的预测。因此,中大建议定期监测慢性乙型肝炎血清HBsAg,尤其是对抗病毒药物的患者来决定何时停药。作者: cwy121 时间: 2011-10-11 13:06