835
CLINICAL SIGNIFICANCE OF PRE-S1 DETECTION IN PATIENTS
WITH CHRONIC HEPATITIS B VIRUS INFECTION
Xingxin Zhang1, Qian Wei1, Yirong Cao2, Jiyao Wang1 and
Jinsheng Guo1, (1)Department of Gastroenterology and
Hepatology, Zhongshan Hospital, Fudan University, Shanghai
Institute of Liver Diseases, (2)Department of Gastroenterology
and Hepatology, Huadong Hospital, Fudan University
Background: Pre-S1 antigen of hepatitis B (pre-S1) is a
component of large surface antigen of hepatitis B virus
(L-HBsAg) In this study, we investigated the correlation
between pre-S1 status and the unfavorable prognosis of
chronic hepatitis B(CHB) infection, including cirrhosis and
hepatocellular carcinoma(HCC) Methods: 840 patients
with chronic HBV infection who visited Zhongshan Hospital
Affiliated to Fudan University from 2016 to 2019 were enrolled
in this study The clinical data of HBV infection, liver function,
blood routine test, coagulation function, liver cancer markers,
hepatobiliary ultrasound, CT or MRI imagings were collected
Single factor analysis and logistic multiple regression analysis
were applied to explore the correlation between pre-S1 status
and other HBV markers, and the risk of cirrhosis and HCC
The correlation between pre-S1 transversions in 144 patients
that had multiple follow-up data and their prognostic events,
anti-HBV drug treatment, and other HBV markers, were also
analyzed T test and Wilcoxon rank sum test were used to
compare the means of measurement data Chi square test
and Fisher exact test were used to compare the average levels
of counting data Stata 14 2 software was used for statistical
analysis Results: 1) Quantitative HBsAg was significantly
higher in the Pre-S1 positive group than in the negative
group (Z=-15 983, P=0 000) The single test Pre-S1 positive
rates within the interval of HBsAg<1000COI, 1000~2000COI,
2000~5000COI, >5000COI were significantly different (7.28%,
42 53%, 71 31%, 87 43%, c2=317 9634, P=0 000) Similarly,
the single test Pre-S1 positive rates within the interval of HBV
DNA levels <10^3 IU/ml, 10^4~10^5 IU/ml, and 10^6~10^8 IU/
ml were also significantly different (61.34%, 74.70%, 86.36%,
c2=15 7447, P=0 000) The positive rate of HBeAg in pre-S1
positive group was higher than that in pre-S1 negative group
( c2=20 8575, P=0 000) 2) The results of logistic multiple
regression analysis showed that single pre-S1 test negative
(OR=1 7), male gender (OR=3 9), Sustained Pre-S1 negative
in multiple follow-up tests (OR=6 3), age and quantitative
HBsAg were associated with HCC risk 4) There were no
association between anti-HBV drugs treatment with Pre-S1
transversions (c2=4.8954, P=0.180). No significant association
was found between pre-S1 status or transversions with the
risk of cirrhosis Conclusion: Pre-S1 positive reflects the
existence of HBV and viral replication, which is similar to
other HBV markers including HBsAg, HBeAg and HBV DNA
Currently oral anti-HBV drugs have no significant impact on
Pre-S1 status or its serological transversions It should be
notified that sustained pre-S1 and HBsAg, and/or HBV DNA
positive reflects HBV un-clearance, and sustained pre-S1
negative with HBsAg positive are associated with a higher
HCC risk in CHB patients. 作者: StephenW 时间: 2020-10-31 17:24