HBsAg水平帮助预测低乙肝DNA浓度患者疾病进展

肝胆速递

http://www.ncbi.nlm.nih.gov/pubmed/22941922
Hepatology. 2012 Sep 3. doi: 10.1002/hep.26041. [Epub ahead of print]

Serum hepatitis B surface antigen levels help predict disease progression in patients with low HBV loads.HBsAg水平帮助预测低乙肝DNA浓度患者疾病进展

Tseng TC, Liu CJ, Yang HC, Su TH, Wang CC, Chen CL, Hsu CA, Kuo SF, Liu CH, Chen PJ, Chen DS, Kao JH.
Source

Division of Gastroenterology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital Taipei Branch, Taipei, Taiwan; Graduate Institute of Clinical Medicine, Buddhist Tzu Chi General Hospital Taipei Branch, Taipei, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan.
Abstract
BACKGROUND & AIMS:

Chronic hepatitis B patients with high viral loads are at increased risk of cirrhosis and hepatocellular carcinoma (HCC). In those with low viral loads, higher hepatitis B surface antigen (HBsAg) levels have been shown to predict HCC development. However, little is known about the difference in risk for other hepatitis B virus (HBV)-related adverse outcomes with varying HBsAg levels.
METHODS:

A total of 1068 Taiwanese hepatitis B e antigen (HBeAg)-negative HBV carriers with serum HBV DNA level <2000 IU/mL at baseline were followed for a mean duration of 13.0 years. Patients were categorized based on their HBsAg levels, and the relationships between HBsAg level and development of HBeAg-negative hepatitis, hepatitis flare, and cirrhosis were investigated.
RESULTS:

Of the 1068 patients with low viral loads, 280 developed HBeAg-negative hepatitis with an annual incidence rate of 2.0%. HBsAg level, but not HBV DNA level, was found to be a risk factor for HBeAg-negative hepatitis. Multivariate analysis showed that the adjusted hazard ratio in patients with HBsAg level ≧1000 versus <1000 IU/mL was 1.5 (95% confidence interval, 1.2-1.9). The positive correlation was present when evaluating other endpoints, including hepatitis flare and cirrhosis, and remained consistent when the study population was restricted to those with normal alanine aminotransferase (ALT) level at baseline. The annual incidence rate of HBeAg-negative hepatitis was lowered to 1.1% in those with low levels of HBV DNA, HBsAg, and ALT.
CONCLUSIONS:

In HBeAg-negative patients with low viral loads and genotype B or C virus infection, a higher HBsAg level can predict disease progression. HBsAg <1000 IU/mL in combination with low levels of HBV DNA and ALT help define minimal-risk HBV carriers. (HEPATOLOGY 2012.

肝胆速递

杂志。 2012年9月3日。 DOI：10.1002/hep.26041。 [EPUB的提前打印]
血清乙肝表面抗原水平在与HBV负荷低的患者中，帮助预测疾病进展。
王苏TH，曾TC，CJ刘，杨HC，CC，陈CL，CA许，郭SF，刘CH，陈丕，陈德尚，高JH。
源

胃肠科，内科，佛教慈济综合医院台北分行，台北，台湾医学研究所，佛教慈济综合医院台北分行，台北，台湾大学医学院，慈济大学，花莲，台。
抽象
背景与目的：

高病毒载量的慢性乙肝患者肝硬化和肝细胞癌（HCC）的危险性增加。在那些具有低病毒载量，已经示出了较高的B型肝炎表面抗原（HBsAg）的水平来预测HCC的发展。然而，鲜为人知的是，其他B型肝炎病毒（HBV）相关的不良后果风险的差异与不同的HBsAg水平。
方法：

一共有1068台湾肝炎乙e抗原（HBeAg）阴性乙肝病毒携带者血清HBV DNA水平<2000 IU / mL的基线，随访的平均时间为13.0年。病人被分为HBsAg水平的基础上，HBsAg水平和发展HBeAg阴性肝炎，肝炎爆发，和肝硬化之间的关系进行了研究。
结果：

1068低病毒载量的患者中，有280 HBeAg阴性肝炎，每年的发病率为2.0％。 HBsAg水平，但HBV DNA水平，发现是HBeAg阴性肝炎的危险因素。多因素分析显示，患者的HBsAg水平，调整后的危险比≧1000与1000 IU / mL的1.5（95％可信区间为1.2-1.9）。在呈正相关性进行评估时，其他端点，包括肝炎耀斑和肝硬化，研究人群仅限于那些正常的谷丙转氨酶（ALT）水平在基线时，保持一致。 HBeAg阴性肝炎的年发病率下降至1.1％，乙肝表面抗原，HBV DNA和ALT水平低。
结论：

在HBeAg阴性患者与低病毒载量和基因型B或C病毒感染，有较高的乙肝表面抗原水平可以预测疾病的进展。乙型肝炎表面抗原（HBsAg）<1000 IU / mL的HBV DNA和ALT水平低结合帮助，定义风险最小的乙肝病毒携带者。 （肝胆病2012年。

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