EASL 2013:早期血清乙型肝炎病毒大表面蛋白水平：一个强有力

StephenW

Abstract 783
     
EARLY SERUM HEPATITIS B VIRUS LARGE SURFACE PROTEIN LEVEL: A STRONG PREDICTOR OF VIROLOGICAL RESPONSE FOR PEGINTERFERON THAN ENTECAVIR IN HBEAG-POSITIVE CHRONIC HEPATITIS B   
     
X.J. Zhu*, Q.M. Gong, D.M. Yu, D.H. Zhang, L.L. Gu, Y. Han, J. Chen, X.X. Zhang
Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. *[email protected]

Background and aims: Quantitative hepatitis B surface antigen (HBsAg) is emerging as useful tools for predicting antiviral effect, but the detection includes all three forms of circulating particles in the serum. The study aims to evaluate the usefulness of serum hepatitis B virus large surface protein (LHBs) levels for predicting antiviral treatment effect.
Methods: A total of 62 hepatitis B e antigen (HBeAg) positive patients were enrolled: 21 patients received peginterferon (Peg-IFN) treatment and 41 patients received entecavir (ETV) treatment. Quantification of LHBs, HBsAg and HBV DNA was carried out at baseline and during antiviral therapy (weeks 4, 12, 24, 36 and 48). Virological response (VR) was defined as an undetectable HBV DNA level (< 1000 copies/mL) after 48 weeks of therapy. Patients who exhibited HBeAg loss or seroconversion at week 48 were regarded as serological response (SR).
Results: The serum LHBs concentration positively correlated with HBV DNA and HBsAg (r = 0.635 and 0.588, respectively). During week 48 of Peg-IFN and ETV therapy, LHBs and HBV DNA level decreased significantly in a biphasic manner and HBsAg level tended to decrease slowly. In Peg-IFN group, the cutoff of 88.46 U/mL in serum LHBs at week 4 gave the best area under the receiver operating characteristic curve (AUC = 0.96) with sensitivity, specificity, positive predictive value and negative predictive value of 100%, 85.7%, 88.9% and 100% in association with VR. The predictive model incorporating LHBs, HBsAg and HBV DNA can discriminate VR at baseline (AUC = 0.79) and show association with SR at week 12 (AUC = 0.80).
Conclusions: On-treatment quantification of serum LHBs could be a useful parameter for predicting VR in patients with Peg-IFN. Combining LHBs, HBsAg and HBV DNA can predict VR and SR more effectively and earlier.


Assigned speakers:
Dr. Xue Zhu, Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , China

Assigned in sessions:
26.04.2013, 09:00-18:00, Poster Session, P02-07c, Category 07c: Viral Hepatitis B & D: Clinical (therapy, new compounds, resistance), Poster Area

StephenW

背景和目的：定量B型肝炎表面抗原（HBsAg）是一种新兴的预测抗病毒效果的有用的工具，但检测包括所有三种形式的血清中的循环颗粒。本研究旨在评价血清乙肝病毒大表面蛋白（LHBs的）的水平，预测抗病毒治疗效果的用处。
方法：共62肝炎乙e抗原（HBeAg）阳性例患者入组21例患者接受聚乙二醇干扰素（PEG-IFN）治疗，41名患者接受恩替卡韦（ETV）治疗。进行了基线和抗病毒治疗期间（4周，12，24，36和48）的量化，LHBs的，HBsAg和HBV DNA。病毒学应答（VR）被定义为一个不到HBV DNA水平（<1000拷贝/毫升）后48周的治疗。被视为展出48周时的HBeAg转阴或血清学转换的患者血清学反应（SR）。
结果：血清LHBs的浓度正相关，与HBV DNA和HBsAg相关（r = 0.635和0.588，分别）。第48周PEG-IFN和ETV治疗，LHBs的HBV DNA水平下降明显一个双相的方式和HBsAg的水平缓慢下降的趋势。 PEG-IFN组，根据受试者工作特征曲线（AUC = 0.96），敏感性，特异性，阳性预测值和阴性预测值100％，截止88.46 U / ml的在血清LHBs的4周给最好的地区在与VR的85.7％，88.9％和100％。 LHBs的预测模型，可以区分HBsAg和HBV DNA与SR VR基线（AUC = 0.79）和展览协会在第12周（AUC = 0.80）。
结论：在处理定量血清LHBs的可能是一个有用的参数预测VR患者PEG-IFN。 HBsAg和HBV DNA结合LHBs的，可以预测VR和SR更有效和更早。

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