低B型肝炎病毒载量的患者血清乙型肝炎表面抗原水平有助于

StephenW

Serum hepatitis B surface antigen levels help predict disease progression in patients with low hepatitis B virus loads†
低B型肝炎病毒载量的患者血清乙型肝炎表面抗原水平有助于预测疾病进展†

    Tai-Chung Tseng1,3,8,
    Chun-Jen Liu2,3,
    Hung-Chih Yang2,6,
    Tung-Hung Su2,3,
    Chia-Chi Wang1,8,
    Chi-Ling Chen3,
    Cheng-An Hsu7,
    Stephanie Fang-Tzu Kuo9,
    Chen-Hua Liu2,3,
    Pei-Jer Chen2,3,
    Ding-Shinn Chen2,3,
    Jia-Horng Kao2,3,4,5,‡,*

Article first published online: 6 DEC 2012

DOI: 10.1002/hep.26041
    1    Division of Gastroenterology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital Taipei Branch, Taipei, Taiwan
    2    Division of Gastroenterology, Department of Internal Medicine, Taipei, Taiwan
    3    Graduate Institute of Clinical Medicine, Taipei, Taiwan
    4    Hepatitis Research Center, and the Departments of Medical Research, Taipei, Taiwan
    5    Departments of Medical Research, Taipei, Taiwan
    6    Departments of Microbiology, Taipei, Taiwan
    7    Laboratory Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
    8    School of Medicine, Tzu Chi University, Hualien, Taiwan
    9    St. Vincent's Hospital, Melbourne, Victoria, Australia


Abstract

Chronic hepatitis B patients with high viral loads are at increased risk of cirrhosis and hepatocellular carcinoma (HCC). In patients 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. A total of 1,068 Taiwanese hepatitis B e antigen (HBeAg)-negative HBV carriers with serum HBV DNA level <2,000 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. 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 an HBsAg level ≥1,000 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 patients with low levels of HBV DNA, HBsAg, and ALT. Conclusion: In HBeAg-negative patients with low viral loads and genotype B or C virus infection, a higher HBsAg level can predict disease progression. HBsAg <1,000 IU/mL in combination with low levels of HBV DNA and ALT help define minimal-risk HBV carriers. (HEPATOLOGY 2013)

StephenW

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。在低病毒载量，患者已经示出了较高的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。总共有1,068台湾B型肝炎e抗原（HBeAg）阳性阴性的HBV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。 1068低病毒载量的患者中，有280开发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，调整后的危险比为患者HBsAg水平≥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。每年的发病率下降至1.1％，HBeAg阴性肝炎患者，乙肝表面抗原，HBV DNA和ALT水平低。结论：在低病毒载量和基因型B或C病毒感染的HBeAg阴性患者，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）<1,000 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2013年）

咬牙硬挺

感谢分享

咬牙硬挺

感谢分享