aasld2014:在乙肝耀斑高AFP是与乙肝表面抗原国统会在治疗过程

StephenW

1893Higher AFP during hepatitis B flare is associated with greater reduction in HBsAg during Nuc therapyRachel Wen-Juei Jeng1,3, Yi-Cheng Chen1,3, Ming-Ling Chang1,3, Yun -Fan Liaw2,3;1Division of Hepatology, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou branch, Taipei, Taiwan; 2Liver research unit, Chang-Gung Memorial Hospital, Linko, Taipei, Taiwan; 3Chang Gung University, Taipei, Taiwan
Abstract: Background: The reduction of hepatitis B surface antigen (HBsAg)level during nucleos(t)ide analog (Nuc) therapy is small and only in patients with serum alanine transferase (ALT) elevation, implicating the role of hepatocytolysis (J Hepatol 2011; 54:449-54). Serum alphafetoprotein (AFP) level over 100 ng/mL during hepatitis flare usually represents more extensive hepatocytolysis or bridging hepatic necrosis (Liver 1986; 6:133-7). Whether higher AFP levels during hepatitis flare are associated with greater reduction in HBsAg level during Nuc therapy is unknown.
Patients and methods: The study included 217 chronic hepatitis B patients who had adequate AFP measurement during hepatitis B flare (ALT ≥ 5X ULN). HBsAg level was measured at baseline, 6 month and 12 month of Nuc therapy using Elecsys HBsAg II (Roche Diagnostics, Indianapolis, IN, USA). The results were analyzed according to AFP levels (<20, 20-50, 50-100 and ≥ 100 ng/mL) and ALT levels (5-10X, 10-20X, > 20XULN), respectively, and compared with that of 44 CHB patients with ALT < 5X ULN. Results: The results (Table 1) showed the higher the AFP level during hepatitis flare, the greater the reduction in HBsAg level during Nuc therapy. The reduction in HBsAg level was also greater in patients with higher ALT levels. Stepwise multiple linear regression analysis showed that AFP level, not ALT level, was significantly associated with greater reduction in 6th month and 1st year HBsAg levels.
Conclusion: The increase of AFP during hepatitis B flare, reflecting more extensive hepatocytolysis and subsequent regeneration, contributes to greater reduction in HBsAg level during Nuc therapy.
Log10 reduction in HBsAg level in patients with different AFP and ALT levels

Linear trend of HBsAg Log reduction at 6th month by ALT and AFP are P=0.000, respectively.
Linear trend of HBsAg Log reduction at 12th month by ALT and AFP are P=0.000, respectively.
AFP: alphafetoprotein; ALT: alanine transaminase; ULN: upper limit of normal; HBsAg: hepatitis B surface antigen.
Disclosures:
Yun -Fan Liaw - Advisory Committees or Review Panels: Roche; Grant/Research Support: Roche
The following people have nothing to disclose: Rachel Wen-Juei Jeng, Yi-Cheng Chen, Ming-Ling Chang

StephenW

1893年
在乙肝耀斑高AFP是与乙肝表面抗原国统会在治疗过程中更大的减少有关
瑞秋文寿永Jeng1,3，易诚Chen1,3，明陵Chang1,3，云 - 风扇Liaw2,3;
1区肝病，胃肠病学和肝病，长庚纪念医院林口分公司，台北，台湾系; 2Liver科研单位，长庚纪念医院林口，台北，台湾; 3Chang长庚大学，台湾台北

背景：B型肝炎表面抗原（HBsAg）水平的过程中核苷的减少（吨）的ide类似物（NUC）治疗小并且仅在患者的血清丙氨酸转移酶（ALT）的升高，暗示hepatocytolysis的作用（肝脏病学杂志2011 ;54：449-54）。血清甲胎蛋白（AFP）水平超过100纳克/在肝炎暴发毫升，通常代表了更广泛的hepatocytolysis或桥接坏死肝（肝1986;6：133-7）。不管是在肝炎暴发高AFP水平与乙肝表面抗原水平国统会在治疗过程中更大的减少有关联尚不清楚。患者与方法：本研究包括217慢性乙肝患者谁在乙肝耀斑（ALT≥5×ULN）有足够的AFP测定。 HBsAg的水平，测定基线，6个月和12个月国统疗法使用的Elecsys HBsAg的II（Roche Diagnostics公司，印第安纳波利斯，IN，USA）组成。根据AFP水平（<20，20-50，50-100和≥100毫微克/毫升）和ALT水平（5到10倍，10-20X，>20XULN）的结果进行分析，分别和与44相比CHB患者ALT<5×ULN。结果：结果（表1）中肝炎耀斑表明较高的AFP水平，更大国统会在治疗过程中在HBsAg的水平的降低。在乙肝表面抗原水平下降也较大的患者具有更高的ALT水平。逐步多元线性回归分析表明，AFP水平，而不是ALT水平，是显著，在6个月和1年HBsAg水平更高的减少有关。结论：AFP的过程中乙肝耀斑的增加，反映了更广泛的hepatocytolysis和随后的再生，有助于在乙肝表面抗原水平的国统会在治疗过程中较大的减少。

LOG10减少的HBsAg水平在患者不同AFP和ALT水平
图片

乙肝表面抗原数减少为6个月按ALT和AFP的线性趋势为P=0.000，分别。

乙肝表面抗原日志还原的第12个月按ALT和AFP的线性趋势为P=0.000，分别。

法新社：甲胎蛋白; ALT：丙氨酸氨基转移酶; ULN：正常值上限;乙肝表面抗原：乙肝表面抗原。

披露：

韵 - 风扇LIAW - 咨询委员会或审查小组：罗氏公司;格兰特/研究支持：罗氏

下面的人都没有透露：瑞秋文寿永钲，忆郑贞铭泠嚓嗯