不同的Seromarkers预测慢性乙型肝炎不同的里程碑

StephenW

<http://onlinelibrary.wiley.com/doi/10.1002/hep.27083/abstract>

Distinct Seromarkers Predict Different Milestones of Chronic Hepatitis B
Progression

Jessica Liu1,
Hwai-I Yang1,2,3,
Mei-Hsuan Lee4,
Richard Batrla-Utermann5,
Chin-Lan Jen1,
Sheng-Nan Lu6,
Li-Yu Wang7,
San-Lin You1,
Chuhsing Kate Hsiao8,
Chien-Jen Chen1,8,*,
for the R.E.V.E.A.L.-HBV Study Group
DOI: 10.1002/hep.27083
Copyright © 2014 American Association for the Study of Liver Diseases

Vol. 59 Issue 3

Hepatology
Accepted Article (Accepted, unedited articles published online and citable.
The final edited and typeset version of record will appear in future.)

Abstract

Background and Aims: Spontaneous seroclearance of hepatitis B e antigen
(HBeAg) and HBV DNA undetectability are important milestones of chronic
hepatitis B and major treatment endpoints of antiviral therapy. This study
investigates the role of serum hepatitis B surface antigen (HBsAg) levels
and establishes prediction models for predicting HBeAg seroclearance and
HBV DNA undetectability.

Methods: A total of 2139 HBsAg-seropositive, anti-HCV-seronegative, and
treatment-naïve participants without liver cirrhosis at study entry were
included. Spontaneous HBeAg seroclearance and HBV DNA undetectability were
analyzed in 431 HBeAg-seropositive participants, and 1708
HBeAg-seronegative participants, respectively. Regression coefficients of
predictors in Cox proportional hazard models were converted into integer
scores for predicting seroclearance, and predictive accuracy was assessed
with time-dependent ROC curves.

Results: HBV DNA level was the most important predictor of HBeAg
seroclearance, but Serum HBsAg level was the most significant predictor of
HBV DNA undetectability. Compared to individuals with HBsAg levels
≥10,000 IU/mL, the multivariate-adjusted rate ratio (95% confidence
interval) of HBV DNA undetectability was 1.20 (0.62-2.30), 2.49
(1.31-4.75), and 6.08 (3.19-11.61) for those with serum HBsAg levels of
1000-9999, 100-999, and <100 IU/mL, respectively. The AUROCs of the
prediction models for predicting the five- and ten-year probabilities of
HBeAg seroclearance and HBV DNA undetectability were 0.85 (0.80-0.90) and
0.78 (0.73-0.83) for HBeAg seroclearance, and 0.77 (0.72-0.82) and 0.73
(0.70-0.76) for HBV DNA undetectability.

Conclusion: Prediction models incorporating important host and virus
factors can predict HBeAg seroclearance and HBV DNA undetectability. Serum
HBsAg levels rather than HBV DNA is the most important predictor of
spontaneous HBV DNA undetectability. Serum HBsAg levels should be monitored
in the management of patients with HBeAg-seronegative chronic hepatitis B.
(Hepatology 2014;)

StephenW

不同的Seromarkers预测慢性乙型肝炎不同的里程碑
级数

杰西卡柳1 ，
怀我杨1 ， 2,3 ，
梅轩Lee4 ，
理查德Batrla - Utermann5 ，
秦岚Jen1 ，
盛楠LU6 ，
李钰Wang7 ，
三林友1 ，
Chuhsing凯特Hsiao8 ，
建仁晨1 ， 8 ， * ，
为R.E.V.E.A.L.乙肝病毒研究小组
DOI ： 10.1002/hep.27083
版权所有©肝病研究2014年美国协会

第一卷。 59第3期

肝病
第二十接受（接受，未经编辑的文章在网上和可引述出版。
记录的最后的编辑和排版版本将出现在未来。 ）

摘要

背景和目的：乙肝e抗原的自发廓清
（ HBeAg）阳性和HBV DNA不可检测是慢性的重要里程碑
乙肝抗病毒治疗的主要治疗终点。本研究
探讨血清乙肝表面抗原（HBsAg）水平的作用
并建立预测模型预测的HBeAg血清廓清和
HBV DNA不可检测。

方法：共有2139例HBsAg阳性，抗-HCV阴性，而
无肝硬化进入研究治疗初治参与者
包括在内。自发性HBeAg血清廓清和HBV DNA均不可检测
在431例HBeAg阳性的参与者分析， 1708
e抗原阴性的参与者，分别。的回归系数
在Cox比例风险模型预测转换为整数
比分预测廓清，而预测的准确性进行评估
与时间相关的ROC曲线。

结果： HBV DNA水平是大三阳的最重要的预测
血清清除，但血清的HBsAg水平是最显著预测
HBV DNA不可检测。相比与HBsAg水平的个体
≥10,000 IU / mL时，多变量调整率比（ 95％置信
HBV DNA不可检测的间隔时间）为1.20 （ 0.62-2.30 ） ， 2.49
（ 1.31-4.75 ） ，和6.08 （ 3.19-11.61 ），对于那些血清HBsAg水平
1000-9999 ， 100-999 ，和< 100 IU /毫升。的的AUROCs
预测模型预测五年和十年的概率
HBeAg的血清清除和HBV DNA不可检测分别为0.85 （ 0.80-0.90 ）和
0.78 （ 0.73-0.83 ）治疗HBeAg血清廓清和0.77 （ 0.72-0.82 ）和0.73
（ 0.70-0.76 ）的HBV DNA不可检测。

结论：结合重要的宿主和病毒预测模型
因素可以预测HBeAg的血清清除和HBV DNA不可检测。血清
HBsAg水平，而不是HBV DNA是最重要的预测
自发性HBV DNA不可检测。血清HBsAg水平应监测
在例HBeAg阴性慢性乙型肝炎的管理
（肝脏病学2014 ;)