自发性HBeAg血清转换的患者结合HBsAg下降和HBV DNA水平预测临

StephenW

Hepatology International
June 2013, Volume 7, Issue 2, pp 489-499

Combining the HBsAg decline and HBV DNA levels predicts clinical outcomes
in patients with spontaneous HBeAg seroconversion

Shih-Cheng Yang,
Sheng-Nan Lu,
Chuan-Mo Lee,
Tsung-Hui Hu,
Jing-Houng Wang,
Chao-Hung Hung,
Chi-Sin Chang,
Chien-Hung Chen

Abstract

Purpose
The aim was to investigate whether the quantitation of the hepatitis B
surface antigen (HBsAg) and hepatitis B virus (HBV) DNA levels can predict
HBV reactivation and advanced liver disease after spontaneous hepatitis B e
antigen (HBeAg) seroconversion.

Methods
A total of 121 patients who experienced spontaneous HBeAg seroconversion
were included in this longitudinal study. Serial HBsAg and HBV DNA levels
were measured before and after HBeAg seroconversion.

Results
Of the 121 patients, 32 experienced HBV reactivation and six achieved an
HBsAg loss after HBeAg seroconversion during the follow-up period. The
decline in the HBsAg level was considerably more pronounced in patients
without HBV reactivation when compared to those with HBV reactivation (p =
0.016). Multivariate analysis revealed that the age of>40 years at HBeAg
seroconversion, male sex, and HBsAg decline, and HBV DNA levels at month 12
after HBeAg seroconversion were independent factors for the development of
HBeAg-negative hepatitis. All the six patients who achieved HBsAg loss had
HBsAg level of <1,000 IU/mL at month 12 after HBeAg seroconversion (p <
0.001). The risk of HBeAg-negative hepatitis, cirrhosis, and HCC was
substantially increased in patients who had a combination of both, i.e., no
decline in the HBsAg level and HBV DNA level of>104 copies/mL at month 12
after HBeAg seroconversion.

Conclusions
Combining HBsAg reduction and HBV DNA levels at month 12 after HBeAg
seroconversion was a useful marker to predict clinical outcomes in
spontaneous HBeAg seroconverters. HBsAg level of <1,000 IU/mL at month 12
after HBeAg seroconversion could predict the HBsAg loss after HBeAg
seroconversion.

StephenW

的
其目的是调查是否乙肝定量
表面抗原（HBsAg），乙型肝炎病毒（HBV）DNA水平可以预测
HBV再激活和晚期肝病后自发乙肝e
抗原（HBeAg）血清学转换。

方法
共有121例患者经历自发性HBeAg血清转换
被列入这项纵向研究。串行HBsAg和HBV DNA水平
之前和HBeAg血清转换后测定。

结果
的121例患者中，32名经验丰富的HBV再激活和六个实现
在随访期间HBeAg血清转换后的HBsAg消失。该
相当多的患者明显的HBsAg水平下降
无HBV再激活时相比，那些与HBV再激活（P =
0.016）。多因素分析显示，年龄> 40岁，大三阳
在本月12日的下降血清学转换，男性和HBsAg和HBV DNA水平
HBeAg血清转换后的独立危险因素的发展
HBeAg阴性肝炎。所有六名患者达到HBsAg消失
乙肝表面抗原水平<1,000 IU / mL的HBeAg血清转换后12个月（P​​ <
0.001）。 HBeAg阴性肝炎，肝硬化和肝癌的风险
两者的组合的患者，也就是说，不大幅增加
的HBsAg和HBV DNA> 104拷贝/ ml，在12个月的水平下降
HBeAg血清转换后。

结论
在12个月后HBeAg的减少结合的HBsAg和HBV DNA水平
血清学转换是一个有用的标记，预测临床结果
自发性HBeAg血清转化。在本月12日<1000 IU / mL的乙肝表面抗原水平
HBeAg血清转换后，可以预测HBsAg消失后大三阳
血清学转换。

咬牙硬挺

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