在接受干扰素治疗HBeAg阳性患者乙肝表肝面抗原表达的演变

StephenW

Journal of Gastroenterology
February 2014, Volume 49, Issue 2, pp 356-362
Clinical significance and evolution of hepatic HBsAg expression in HBeAg-positive patients receiving interferon therapy

    Tung-Hung Su,
    Chun-Jen Liu,
    Hung-Chih Yang,
    Yung-Ming Jeng,
    Huei-Ru Cheng,
    Chen-Hua Liu,
    Tai-Chung Tseng,
    Thai-Yen Ling,
    Pei-Jer Chen,
    Ding-Shinn Chen,
    Jia-Horng Kao
  
Abstract
Background

Serum hepatitis B surface antigen (HBsAg) level is important in the management of chronic hepatitis B (CHB). However, it is unclear whether serum HBsAg reflects its expression in liver and the hepatic HBsAg evolution following interferon therapy.
Methods

Forty-five HBeAg-positive CHB patients receiving interferon-based therapy within a randomized, controlled, multicenter study during 1998–1999 were included. The hepatic HBsAg expressions were categorized into cytoplasmic, inclusion, marginal and negative patterns by immunohistochemical staining. The HBsAg-positive hepatocytes were quantified by image-based cytometry and correlated to HBV serological and virological profiles for clinical implications. The evolution of hepatic HBsAg levels was analyzed among 22 patients with paired liver biopsies before and after interferon therapy, sequentially.
Results

There was a positive correlation between pretreatment serum HBsAg and hepatic HBsAg levels (r = 0.67, P < 0.0001). The hepatic HBsAg expression pattern significantly evolved from cytoplasmic/inclusion pattern to marginal/negative pattern after interferon treatment. The serum HBV-DNA, HBsAg and hepatic HBsAg levels all decreased significantly after interferon therapy. Among 36 % patients with HBeAg loss after therapy, pretreatment hepatic HBsAg levels were significantly lower compared with those without HBeAg loss. After multivariate analysis, low pretreatment hepatic HBsAg levels rather than serum HBsAg titers were associated with a higher rate of HBeAg loss (OR: 4.97, 95 % CI: 1.12–22.00, P = 0.035).
Conclusions

The serum HBsAg level positively reflects the HBsAg level in liver which evolves significantly after interferon therapy. A lower hepatic HBsAg level is associated with HBeAg loss after interferon treatment. Hepatic HBsAg may have clinical significance in CHB patients receiving interferon treatment.
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    Japanese Society of Gastroenterology Japanese Society of Gastroenterology

StephenW

中华消化内镜杂志
2014年2月， 49卷，第2期，页356-362
在接受干扰素治疗HBeAg阳性患者的临床意义和肝乙肝表面抗原表达的演变

    东红素，
    淳仁刘，
    洪智扬，
    容明郑，
    惠汝诚，
    陈刘桦，
    台中曾，
    泰彦岭，
    陈培哲，
    陈定信，
    嘉宏高
   


摘要
背景

血清乙肝表面抗原（HBsAg ）水平是很重要的慢性乙型肝炎（CHB ）的管理。然而，目前还不清楚血清HBsAg是否反映了它在肝脏和肝HBsAg的演进以下干扰素治疗表达。
方法

1998-1999年期间接受了一项随机，对照，多中心研究中干扰素为基础的治疗四五HBeAg阳性CHB患者被纳入。肝表达的HBsAg免疫组化染色分为细胞质，包容，边缘和消极的模式。对HBsAg阳性的肝细胞通过基于图像流式细胞仪定量和相关性，为临床意义HBV血清学和病毒学配置文件。肝HBsAg水平的演变中22例配对肝活检进行分析之前和之后的干扰素治疗，按顺序。
结果

有治疗前血清HBsAg和肝HBsAg水平相关（r = 0.67 ， P <0.0001）呈正相关。从胞浆/包模式干扰素治疗后的边际/负格局显著演变肝HBsAg的表达模式。血清HBV-DNA ，乙肝表面抗原和肝HBsAg水平显著干扰素治疗后均下降。其中36 ％的患者治疗后HBeAg消失，与无HBeAg转阴治疗前相比，肝HBsAg水平有显著降低。多变量分析显示，低预处理肝脏HBsAg水平，而不是血清HBsAg滴度均与较高的利率HBeAg消失（ OR ： 4.97 ， 95 ％ CI： 1.12-22.00 ， P = 0.035） 。
结论

该血清HBsAg水平正反映了肝脏其中干扰素治疗后显著演变的HBsAg的水平。较低的肝乙肝表面抗原水平与干扰素治疗后HBeAg消失有关。肝乙肝表面抗原可能有临床意义的接受干扰素治疗慢性乙型肝炎患者。
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