HBsAg ， HBeAg和HBV DNA水平的变化和前C /基本核心启动子突变

StephenW

Hepatology International
October 2013, Volume 7, Issue 4, pp 969-980
HBsAg, HBeAg and HBV DNA level changes and precore/basal core promoter mutations in the natural history of chronic hepatitis B in Indonesian patients

    Turyadi,
    Meta Dewi Thedja,
    Susan Irawati Ie,
    Alida Roswita Harahap,
    Korri Elvanita El-Khobar,
    Martono Roni,
    David Handojo Muljono


Abstract
Introduction

Chronic hepatitis B (CHB) is a state of complex interactions between the hepatitis B virus (HBV) and host. We studied the changes in hepatitis B surface antigen (HBsAg), hepatitis B ‘e’ antigen (HBeAg) and HBV DNA levels, considering the implications of HBV genotype, basal core promoter (BCP) A1762T/G1764A and precore G1896A mutations in CHB.
Methods

One hundred fifty-two treatment-naïve CHB patients were classified into immune-tolerant (IT), immune-clearance (IC), low/non-replicative (LR) and ‘e’-negative hepatitis B (ENH) phases, based on HBeAg status, HBV DNA and ALT levels. HBV DNA was detected and quantified by polymerase chain reaction, then analyzed by sequencing. HBsAg and HBeAg levels were measured serologically.
Results

HBsAg and HBV DNA levels varied between CHB phases, with HBsAg highest in IT and lowest in LR, and HBV DNA high in IT and IC, and lowest in LR. Both markers increased in ENH. Correlation between HBsAg and HBV DNA was significant in IT and IC, modest in ENH, but missing in LR. HBeAg and HBV DNA levels were dissociated in HBeAg-positive patients. Genotypes B and C were similarly distributed, with precore mutations higher in HBeAg-negative patients and BCP mutations comparable in all phases. Temporal association between HBeAg seroconversion and an increase of BCP/precore mutations was observed.
Conclusion

HBsAg and HBV DNA levels were high and correlated in early CHB phases and dissociated after HBeAg seroconversion, indicating different controls affecting HBV replication and HBsAg production. Selection of BCP/precore mutants may affect disease course and explain the HBeAg–HBV DNA dissociation, a precaution for clinical application of quantitative HBeAg.

StephenW

国际肝病
2013年10月，第7卷，第4期，页969-980
的HBsAg ， HBeAg和HBV DNA水平的变化和前C /基本核心启动子突变在印尼患者慢性乙型肝炎的自然史

    Turyadi ，
    元德薇Thedja ，
    苏珊Irawati也就是说，
    ALIDA Roswita Harahap ，
    Korri Elvanita埃尔 - 胡拜尔，
    Martono罗尼，
    大卫Handojo Muljono


摘要
介绍

慢性乙型肝炎（CHB ）是乙型肝炎病毒（ HBV）和主机之间复杂的相互作用的状态。我们研究了改变乙肝表面抗原（HBsAg ） ，乙型肝炎'电子'抗原（HBeAg）和HBV DNA水平，考虑HBV基因型，基本核心启动子（ BCP） A1762T/G1764A和前C区G1896A突变在CHB的影响。
方法

百52治疗初治慢性乙肝患者分为免疫耐受（ IT ） ，免疫清除率（ IC ） ，低/非复制型（ LR）和' E'阴性B型肝炎（ ENH ）阶段的基础上， HBeAg状态， HBV DNA和ALT水平。 HBV DNA的检测和通过聚合酶链反应，然后通过测序分析进行定量。 HBsAg和HBeAg水平血清学测定。
结果

HBsAg和HBV DNA水平CHB阶段之间变化，具有最高的HBsAg在IT和最低的LR和HBV-DNA高的IT和IC ，并以最低的LR 。这两个标记在ENH增加。 HBsAg和HBV-DNA之间的相关性是IT显著及IC ，温和ENH ，但在LR失踪。 HBeAg和HBV DNA水平中分离HBeAg阳性患者。 B，C基因型分布相似，与前C区突变高于HBeAg阴性患者和BCP变异可比的所有阶段。观察HBeAg血清转换，并增加了BCP /前C区突变之间的时间关联。
结论

HBsAg和HBV DNA水平高，并且在早期阶段的慢性乙肝相关性和游离HBeAg血清学转换后，表明影响HBV的复制与HBsAg生产不同的控件。选择BCP /前C区突变可能会影响病程和解释的HBeAg -乙肝病毒DNA解离，一个预防措施的HBeAg定量的临床应用。