标题: Quantitative HBsAg and HBeAg assays in the prediction of virologic response to e [打印本页] 作者: StephenW 时间: 2011-2-17 20:03 标题: Quantitative HBsAg and HBeAg assays in the prediction of virologic response to e
Quantitative HBsAg and HBeAg assays in the prediction of virologic response to
entecavir in patients with chronic hepatitis B
Jung Min Lee1,2, Sang Hoon Ahn1,3,5, Hyon Suk Kim3,6, Hana Park1, Hye Young
Chang4, Do Young Kim1,3,4, Seong Gyu Hwang2, Kyu Sung Rim2, Chae Yoon Chon1,3,4,
Kwang-Hyub Han1,3,5, Jun Yong Park1,3,4,*,†DOI: 10.1002/hep.24221
Hepatology
Accepted Article (Accepted, unedited articles published online for future
issues)
Abstract
Quantitative HBsAg (qHBsAg) and HBeAg (qHBeAg) titers are emerging as useful
tools for measuring viral load and in predicting virologic response (VR) and
serologic response (SR) to peg-interferon therapy. However, the clinical utility
of these assays in patients taking entecavir (ETV) is largely unknown.
Treatment-naïve patients with chronic hepatitis B (CHB) taking ETV for 2 years
were enrolled. qHBsAg and qHBeAg were serially measured using ARCHITECT. From 95
patients (HBeAg-positive: 60.0%), 475 samples were analyzed. The median baseline
log HBV DNA, log qHBsAg, and log qHBeAg were 6.73 (4.04∼9.11) copies/mL, 3.58
(1.17∼5.10) IU/mL, and 1.71 (-0.64∼2.63) PE IU/mL, respectively. In
predicting VR (HBV DNA <60 copies/mL at 24 months) in HBeAg-positive patients,
baseline ALT (p=0.013), HBV DNA (p=0.040), and qHBsAg (p=0.033) were
significant. The AUC of baseline log qHBsAg for predicting VR was 0.823
(p<0.001), with cutoff level of 3.98 IU/mL (9,550 IU/mL, non-logarithmic scale)
yielding the highest predictive value, with a sensitivity 86.8% and specificity
78.9%. As for SR (HBeAg loss at 24 months), reduction of qHBeAg was
significantly greater in SR(+) than SR(–) group. The sensitivity and
specificity was 75.0% and 89.8%, respectively, with decline of 1.00 PE IU/mL at
6 months. With ETV therapy, correlation between HBV DNA and qHBsAg peaked at 6
months in HBeAg-positive patients.
Conclusions: Both qHBsAg and qHBeAg decreased significantly with ETV therapy.
Baseline qHBsAg and on-treatment decline of qHBeAg in HBeAg-positive patients
proved highly useful for predicting VR and SR, respectively. Determination of
qHBsAg and qHBeAg can help to select the appropriate strategy in management of
patients with CHB. However, the dynamic interplay between qHBsAg, qHBeAg, and
HBV DNA during antiviral therapy remains to be elucidated.