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标题: 高水平的乙型肝炎核心相关抗原与慢性HBV中间病毒载量感染 [打印本页]

作者: StephenW 时间: 2019-8-30 14:29 标题: 高水平的乙型肝炎核心相关抗原与慢性HBV中间病毒载量感染

High Level of Hepatitis B Core-related Antigen Associated With Increased Risk of Hepatocellular Carcinoma in Patients With Chronic HBV Infection of Intermediate Viral Load [url=]Tai-Chung Tseng[/url]1,2
, [url=]Chun-Jen Liu[/url]1,2,5
, [url=]Chen-Yang Hsu[/url]8
, [url=]Chun-Ming Hong[/url]1,4
, [url=]Tung-Hung Su[/url]1,2
, [url=]Wan-Ting Yang[/url]2
, [url=]Chi-Ling Chen[/url]5
, [url=]Hung-Chih Yang[/url]1,5,6
, [url=]Yen-Tsung Huang[/url]9
, [url=]Stephanie Fang-Tzu Kuo[/url]10
, [url=]Chen-Hua Liu[/url]1,2
, [url=]Pei-Jer Chen[/url]1,2,5
, [url=]Ding-Shinn Chen[/url]7
, [url=]Jia-Horng Kao[/url]1,2,3,5,∗,[url=]

Correspondence information about the author Jia-Horng Kao[/url]

Email the author Jia-Horng Kao

DOI: https://doi.org/10.1053/j.gastro.2019.08.028

Article Info

Abstract

AbstractBackground & AimsChronic hepatitis B virus (HBV) infection is a risk factor for hepatocellular carcinoma (HCC). Serum levels of HB core-related antigen (HBcrAg) have been associated with active replication of HBV. We investigated whether HBcrAg levels associate with development of HCC, especially in patients who do not require antiviral treatment.

MethodsWe collected data from 2666 adults positive for hepatitis B surface antigen (HBsAg), infected with HBV genotypes B or C and without liver cirrhosis, who had a long-term follow-up at the National Taiwan University Hospital, from 1985 through 2000. All the patients did not have antiviral treatment during the follow-up. Baseline levels of HBV DNA, HBsAg, and HBcrAg were determined retrospectively and participants were followed for a mean time of 15.95 years. The primary endpoint was association between serum level of HBcrAg and HCC development.

ResultsIn the entire cohort, 209 patients developed HCC (incidence rate, 4.91 cases/1000 person-years). We found a positive association between baseline level of HBcrAg and HCC development; HBcrAg level was an independent risk factor in multivariable analysis. In the subgroup of hepatitis B e antigen-negative patients with HBV DNA levels from 2000 to 19,999 IU/mL (intermediate viral load, IVL) and normal levels of alanine aminotransferase, HBcrAg levels of 10 KU/mL or more identified patients at increased risk of HCC (hazard ratio, 4.89; 95% CI, 2.18–10.93). Patients with an IVL and high levels of HBcrAg had a risk for HCC risk that did not differ significantly from that of patients with a high viral load (≥20,000 IU/mL). Patients with an IVL but a low level of HBcrAg had a low risk of HCC with an annual incidence rate of 0.10% (95% CI: 0.04%-0.24%).

ConclusionsIn a long-term follow-up study of 2666 patients with chronic HBV infection (genotypes B or C), level of HBcrAg is an independent risk factor of HCC. Moreover, HBcrAg level of 10 KU/mL identifies patients with an IVL who are at high risk for HCC.

Keywords:[url=https://www.gastrojournal.org/action/doSearch?searchType=quick&occurrences=all<rlSrch=true&searchScope=fullSite&searchText=ERADICATE-B study&code=ygast-site]ERADICATE-B study[/url], virology, [url=https://www.gastrojournal.org/action/doSearch?searchType=quick&occurrences=all<rlSrch=true&searchScope=fullSite&searchText=liver cancer&code=ygast-site]liver cancer[/url], ALT

作者: StephenW 时间: 2019-8-30 14:29

高水平的乙型肝炎核心相关抗原与慢性HBV中间病毒载量感染患者肝细胞癌风险增加有关
Tai-Chung Tseng1,2
，刘春仁1,2,5
，Chen-Yang Hsu8
，Chun-Ming Hong1,4
，Suung-Hung Su1,2
，杨万婷2
，陈志玲5
，Hung-Chih Yang1,5,6
，Yen-Tsung Huang9
，Stephanie Fang-Tzu Kuo10
，刘晨华1,2
，Pei-Jer Chen1,2,5
，Ding-Shinn Chen7
，Jia-Horng Kao1,2,3,5，*，'作者信息关于作者Jia-Horng KaoEmail作者Jia-Horng Kao
DOI：https：//doi.org/10.1053/j.gastro.2019.08.028
showArticle信息

抽象

抽象
背景与目的

慢性乙型肝炎病毒（HBV）感染是肝细胞癌（HCC）的危险因素。 HB核心相关抗原（HBcrAg）的血清水平与HBV的活跃复制有关。我们调查了HBcrAg水平是否与HCC的发展相关，特别是在不需要抗病毒治疗的患者中。
方法

我们从1985年至2000年在国立台湾大学医院接受了长期随访的乙型肝炎表面抗原（HBsAg）阳性，感染HBV基因型B或C，无肝硬化的2666名成人的数据。患者在随访期间未接受抗病毒治疗。回顾性地确定HBV DNA，HBsAg和HBcrAg的基线水平，并且参与者的平均时间为15.95岁。主要终点是血清HBcrAg水平与HCC发展之间的关联。
结果

在整个队列中，209名患者发生HCC（发病率为4.91例/ 1000人年）。我们发现HBcrAg基线水平与HCC发展呈正相关; HBcrAg水平是多变量分析中的独立危险因素。在HBV DNA水平从2000到19,999 IU / mL（中间病毒载量，IVL）和正常丙氨酸氨基转移酶水平的乙型肝炎e抗原阴性患者亚组中，10 KU / mL或更高的HBcrAg水平确定风险增加的患者HCC（危险比，4.89; 95％CI，2.18-10.93）。 IVL和HBcrAg水平高的患者发生HCC风险的风险与病毒载量高（≥20,000IU/ mL）的患者无明显差异。患有IVL但HBcrAg水平低的患者风险较低HCC的年发病率为0.10％（95％CI：0.04％-0.24％）。
结论

在2666例慢性HBV感染患者（基因型B或C）的长期随访研究中，HBcrAg水平是HCC的独立危险因素。此外，HBcrAg水平为10 KU / mL可确定患有HCC高风险的IVL患者。
关键词：
ERADICATE-B研究，病毒学，肝癌，ALT

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