并发HBsAg和抗HBs患者的患病率和临床特征：乙肝研究网络队列

StephenW

J Viral Hepat. 2020 May 4. doi: 10.1111/jvh.13312. [Epub ahead of print]
Prevalence and Clinical Features of Patients with Concurrent HBsAg and Anti-HBs: Evaluation of the Hepatitis B Research Network Cohort.
Lee WM1, King WC2, Schwarz KB3, Rule J1, Sf Lok A4; HBRN Investigators.
Author information

1
    Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX, USA.
2
    Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
3
    Division of Pediatric Gastroenterology, Hepatology and Nutrition, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
4
    Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA.

Abstract

The prevalence of concurrent HBsAg and anti-HBs in plasma of persons with chronic hepatitis B virus (HBV) infection is variable and its clinical significance enigmatic. We examined the prevalence,clinical and virological features of concurrent HBsAg and anti-HBs in children and adults with chronic HBV infection living in North America. A total of 1,462 HBsAg positive participants in the Hepatitis B Research Network pediatric and adult cohorts were included[median age 41 (range 4-80) years, 48% female, 11% white, 13% black, 73% Asians]. Only 18 (1.2%) were found to be anti-HBs positive (≥10 mIU/mL) at initial study evaluation.Distributions of sex, race, HBV genotype, and ALTwere similar between participants with and without concurrent anti-HBs. Those who were anti-HBs positive appeared to be older (median age 50 vs. 41 years,p=0.06), had lower platelet counts (median 197 vs. 222 x 103/mm3 , p=0.07)and higher prevalence of HBeAg (44% vs. 26%, p=0.10). They also had lower HBsAg levels (median 2.0 vs. 3.5 log10 IU/mL, p=0.02).Testing of follow-up samples after a median of 4 years (range 1-6)in 12 of the 18 participants with initial concurrent anti-HBsshowed anti-HBs became undetectable in 6, decreased to <10 mIU/mL in 1and remained positive in 5 participants.Two patients lost HBsAg during follow-up. In conclusion, prevalence of concurrent HBsAg and anti-HBs was low at 1.2%,with anti-HBs disappearing in some during follow-up, in this large cohort of racially diverse children and adults with chronic HBV infection living in North America. Presence of concurrent HBsAg and anti-HBs did not identify a specific phenotype of chronic hepatitis B, nor did it appear to affect clinical outcomes.

This article is protected by copyright. All rights reserved.

PMID:
    32364641
DOI:
    10.1111/jvh.13312

StephenW

J病毒性肝炎。 2020年5月4日。doi：10.1111 / jvh.13312。 [Epub提前发布]
并发HBsAg和抗HBs患者的患病率和临床特征：乙肝研究网络队列的评估。
Lee WM1，King WC2，Schwarz KB3，J1规则，Sf Lok A4； HBRN调查员。
作者信息

1个
美国德克萨斯州达拉斯的德克萨斯大学西南医学中心消化与肝病科。
2
美国宾夕法尼亚州匹兹堡，匹兹堡大学公共卫生研究生院流行病学系。
3
美国马里兰州巴尔的摩市约翰霍普金斯大学医学院儿科胃肠病学，肝病学和营养学系。
4
密歇根大学胃肠病学和肝病学系，美国密西根州安娜堡。

抽象

慢性乙型肝炎病毒（HBV）感染者血浆中同时存在HBsAg和抗HBs的发生率是可变的，其临床意义是难以置信的。我们检查了居住在北美的慢性HBV感染儿童和成人中同时存在HBsAg和抗HBs的流行，临床和病毒学特征。纳入了乙型肝炎研究网络的儿科和成人队列的1,462名HBsAg阳性参与者[中位年龄41岁（4-80岁），女性48％，白人11％，黑人13％，亚洲人73％]。在最初的研究评估中，仅发现18个（1.2％）的抗HBs阳性（≥10mIU / mL）。有和没有并发抗-HBs的受试者之间的性别，种族，HBV基因型和ALT分布相似。抗HBs阳性者似乎年龄较大（中位年龄为50岁对41岁，p = 0.06），血小板计数较低（中位值197对222 x 103 / mm3，p = 0.07）和HBeAg患病率较高（ 44％和26％，p = 0.10）。他们的HBsAg水平也较低（中位数为2.0 vs. 3.5 log10 IU / mL，p = 0.02）。在18位最初同时存在抗HBs的参与者中，有12位在中位4年后（范围1-6）进行了随访样本测试，结果显示6例中未检测到抗HBs，1例中降至<10 mIU / mL，而在1例中保持阳性。 5名参与者。两名患者在随访期间丢失了HBsAg。综上所述，在这个居住在北美的种族差异较大的儿童和成年人的大型队列中，并发HBsAg和抗HBs的患病率很低，仅为1.2％，并且在随访期间某些患者中抗HBs消失。并发HBsAg和抗HBs的存在并未确定慢性乙型肝炎的特定表型，也未影响临床结局。

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PMID：
32364641
DOI：
10.1111 / jvh.13312