标题: 定量HBsAg在2000-20,000 IU / ml之间的HBV DNA患者中的作用 [打印本页] 作者: StephenW 时间: 2021-4-30 15:06 标题: 定量HBsAg在2000-20,000 IU / ml之间的HBV DNA患者中的作用
The role of quantitative HBsAg in patients with HBV DNA between 2000-20,000 IU/ml
Sibel Yıldız Kaya 1 , Bilgül Mete 2 , Abdurrahman Kaya 3 , Ilker Inanç Balkan 2 , Neşe Saltoglu 2 , Ömer Fehmi Tabak 2
Affiliations
Affiliations
1
Department of Infectious Disease, Sungurlu State Hospital, Çorum, Turkey. [email protected].
2
Department of Infectious Disease, Medical School of Cerrahpasa, Istanbul University-Cerrahpasa, Istanbul, Turkey.
3
Department of Infectious Disease, Istanbul Training and Research Hospital, Istanbul, Turkey.
PMID: 33914152 DOI: 10.1007/s00508-021-01854-7
Abstract
Aims: We aimed to determine the contribution of quantitative HBsAg in differentiating chronic infections from chronic hepatitis in HBeAg negative patients with HBV DNA 2000-20,000 IU/ml.
Material and methods: A total of 79 untreated HBeAg negative patients were included. Patients were divided into 3 groups based on HBV DNA levels: group 1 (HBV DNA ≤ 2000 IU/ml), group 2 (HBV DNA: 2000-20,000 IU/ml) and group 3 (HBV DNA > 20,000 IU/ml). We collected serum from all patients for quantitative HBsAg analysis. We compared serum quantitative HBsAg levels with biochemical parameters, HBV DNA and liver biopsy results.
Results: In this study 46 patients were female and the mean age was 42 years. Serum quantitative HBsAg levels were found to be significantly lower in chronic infections compared with chronic hepatitis. There was a positive correlation between quantitative HBsAg and HBV DNA, ALT (alanine aminotransferase), HAI score (histological activity index), fibrosis score and disease stage. The cut-off level of quantitative HBsAg was determined as 4425 IU/ml to differentiate chronic infection from chronic hepatitis. With the test specificity of 95%, we found quantitative HBsAg cut-off values 1026 IU/ml and 20,346 IU/ml for the diagnosis of chronic infection and chronic hepatitis, respectively.
Conclusion: Our study suggests that the quantitative HBsAg ≤ 1000 IU/ml limit value might be used for the diagnosis of chronic infection not only in HBV DNA ≤ 2000 IU/ml but also in patients with HBV DNA between 2000-20,000 IU/ml. In addition, antiviral treatment could be considered in patients with quantitative HBsAg > 20,000 IU/ml and HBV DNA > 2000 IU/ml without further examinations such as liver biopsy.
目的：我们的目的是确定定量HBsAg在区分HBV DNA 2000-20,000 IU / ml的HBeAg阴性患者的慢性感染与慢性肝炎之间的作用。
材料和方法：总共包括79名未经治疗的HBeAg阴性患者。根据HBV DNA水平将患者分为3组：第1组（HBV DNA≤2000 IU / ml），第2组（HBV DNA：2000-20,000 IU / ml）和第3组（HBV DNA> 20,000 IU / ml）。我们收集了所有患者的血清用于HBsAg定量分析。我们将血清定量HBsAg水平与生化参数，HBV DNA和肝活检结果进行了比较。
结果：本研究中有46例患者为女性，平均年龄为42岁。与慢性肝炎相比，慢性感染患者的血清定量HBsAg水平显着降低。定量HBsAg与HBV DNA，ALT（丙氨酸转氨酶），HAI评分（组织活性指数），纤维化评分和疾病分期之间呈正相关。确定HBsAg定量的临界水平为4425 IU / ml，以区分慢性感染和慢性肝炎。测试特异性为95％，我们发现定量的HBsAg截断值分别为1026 IU / ml和20,346 IU / ml，用于诊断慢性感染和慢性肝炎。
结论：我们的研究表明，定量的HBsAg≤1000 IU / ml极限值不仅可用于诊断HBV DNA≤2000 IU / ml的慢性感染，而且可用于HBV DNA在2000-20,000 IU / ml的患者。此外，对于定量HBsAg> 20,000 IU / ml和HBV DNA> 2000 IU / ml的患者，可以考虑进行抗病毒治疗，而无需进一步检查，例如肝活检。