AASLD 2013自发性HBeAg血清转化低病毒载量表面抗原水平与病

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表面抗原水平是与病毒复发低病毒载量
TITLE: Hepatitis B Surface Antigen Level is associated with Viral Reactivation in Spontaneous HBeAg Seroconverters with Low Viral loads
AUTHORS (FIRST NAME, LAST NAME): Tai-Chung Tseng1, Chun-Jen Liu2, Tung-Hung Su2, Hung-Chih Yang2, Pei-Jer Chen2, Ding-Shinn Chen2, Jia-Horng Kao2
Institutional Author(s):
INSTITUTIONS (ALL): 1. Internal Medicine, Buddhist Tzu Chi General Hospital Taipei Branch, Taipei, Taiwan.
2. Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
ABSTRACT BODY: Background & Aims: Level of hepatitis B surface antigen (HBsAg) has been shown to complement HBV DNA level in predicting disease progression in hepatitis B e antigen (HBeAg)-negative patients, especially those with low viral loads. Whether this finding could be seen in spontaneous HBeAg seroconverters remains unclear.
Methods: A cohort of 390 Taiwanese spontaneous HBeAg seroconverters with a mean follow-up period of 7.4 years was enrolled. The relationships between HBV DNA/ HBsAg levels and HBeAg-negative hepatitis/ active viral replication (HBV DNA level ≧2000 IU/mL) were investigated.
Results: In the overall cohort, serum HBV DNA level served as a better predictor for HBeAg-negative hepatitis compared to HBsAg level. However, in those with HBV DNA level <2000 IU/mL, a higher HBsAg level was associated with higher risk of HBeAg-negative hepatitis (P=.015, Figure 1). Multivariate analysis showed the hazard ratio of HBsAg level ≧1000 IU/mL versus <1000 IU/mL was 4.1 (95% confidence interval: 1.3-13.6). When using the endpoint of active viral replication, HBsAg ≧1000 IU/mL remained as an independent risk factor.
Conclusions: Our data show the higher HBsAg level is associated with increased risks of HBeAg-negative hepatitis and active viral replication in spontaneous HBeAg seroconverters with low viral loads.

StephenW

背景与目的：乙肝表面抗原（HBsAg）水平已被证明在预测疾病的进展，以配合HBV DNA水平，乙型肝炎e抗原（HBeAg）阴性的患者，尤其是那些与病毒载量低。可以看出，在自发性HBeAg血清转化这一发现是否仍不清楚。
方法： 390台湾自发性HBeAg血清转化，平均随访期为7.4年的队列被录取。 （ HBV DNA水平之间的关系HBV DNA / HBsAg水平和HBeAg阴性肝炎/病毒复制活跃≧ 2000 IU /毫升）进行了调查。
结果：在整体队列中，血清HBV DNA水平担任一个更好的预测HBsAg的水平相比， HBeAg阴性肝炎。然而，在那些与HBV DNA水平<2000 IU / mL时，较高的乙肝表面抗原水平伴有HBeAg阴性肝炎的风险较高（P = 0.015 ，图1） 。多因素分析显示，乙肝表面抗原水平的危险比≧ 1000 IU / mL对< 1000 IU /毫升为4.1 （95％可信区间为1.3-13.6 ） 。当使用端点病毒复制活跃，乙肝表面抗原≧ 1000 IU / mL的仍然作为一个独立的危险因素。
结论：我们的数据显示，更高的HBsAg水平与HBeAg阴性肝炎病毒复制活跃，病毒载量低的自发性HBeAg血清转化的风险增加。

StephenW

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