乙肝e抗原血清学清除后，乙肝表面抗原水平：纵向随访研究

StephenW

Viral Hepatitis
Hepatitis B surface antigen levels after hepatitis B e-antigen seroclearance: a longitudinal follow-up study

    James Fung1,2,3,
    Wai-kay Seto1,
    Danny Ka-ho Wong1,2,
    Ching-lung Lai1,2 and
    Man-fung Yuen1,2,*

Article first published online: 4 JUN 2014

DOI: 10.1111/liv.12596
Abstract
Background & Aims

The role of quantitative hepatitis B surface antigen (HBsAg) after hepatitis B e-antigen (HBeAg) seroclearance is not well defined. To determine the role of HBsAg levels in predicting significant viremia and hepatitis flares after HBeAg seroclearance.
Methods

A total of 228 chronic hepatitis B patients with spontaneous HBeAg seroclearance were included. Patients were followed up regularly at 3–6 monthly intervals with routine liver biochemistry and hepatitis B serology. Levels of HBV DNA and HBsAg were measured at yearly intervals for up to 5 years after HBeAg seroclearance.
Results

The median log HBsAg and HBV DNA level after HBeAg seroclearance was 3.52 IU/ml and 4.13 IU/ ml respectively, with no significant correlation observed between them (P = 0.572). The HBV DNA at HBeAg seroclearance was 4.13 log IU/ml, compared with 3.12 log IU/ml after 5 years (P < 0.001). No significant change was observed for HBsAg levels (P = 0.991). Hepatitis B flares occurred in 76 (33.3%) patients. Patients who developed hepatitic flares compared with those without hepatitic flares were older (40 vs. 36 years, P = 0.001), had a higher HBV DNA at the time of HBeAg seroclearance (4.70 vs. 3.77 log IU/ml, P =< 0.001), and more likely to be males (42.7% vs. 23.4%, P = 0.002) respectively. There was no difference in HBsAg levels between those with and without hepatitis flare (3.54 vs. 3.52 log IU/ml respectively, P = 0.555).
Conclusion

HBV DNA levels, but not HBsAg levels, after HBeAg seroclearance were associated with subsequent significant viremia and hepatitic flares. Male gender and older age was associated with significant viremia.

StephenW

病毒性肝炎
乙肝e抗原血清学清除后，乙肝表面抗原水平：纵向随访研究

    詹姆斯Fung1,2,3，
    伟琦Seto1，
    丹尼家豪Wong1,2，
    李金龙Lai1,2和
    文烽Yuen1,2，*

文章首次在网上公布：2014年6月4日

DOI：10.1111/ liv.12596
抽象
背景与目的

定量乙肝表面抗原（HBsAg）乙型肝炎e抗原（HBeAg）阳性血清清除后的作用并不明确。为了确定HBsAg水平的e抗原血清学清除后预测显著病毒血症和肝炎发作的作用。
方法：

总共有228慢性乙型肝炎患者的自发性HBeAg血清学清除都包括在内。患者定期随访3-6每月一次例行肝脏生化指标及乙肝血清学。 HBV DNA与HBsAg水平进行测量，在每年的间隔大三阳转阴后长达5年。
结果

中位数日志HBsAg和HBV DNA水平的HBeAg血清清除后为3.52 IU/ ml和4.13 IU/ ML分别与它们之间的观察（P =0.572）无显著的相关性。对HBV DNA的转阴大三阳是4.13日志IU/ ml，用3.12日志IU/5年（P <0.001）后毫升进行比较。观察到HBsAg水平（P=0.991）无显著的变化。乙肝耀斑发生在76（33.3％）的患者。谁开发肝炎发作与无肝炎耀斑相比，患者年龄较大（40与36年，P =0.001），有较高的HBV DNA的转阴的HBeAg（4.70与时间3.77日志IU/ ml时，P =<0.001 ），更可能是男性（分别42.7％和23.4％，P= 0.002）。还有那些有和无肝炎暴发的HBsAg水平无差异（3.54与3.52日志IU/ mL的分别，P=0.555）。
结论

HBV DNA水平，而不是HBsAg水平，之后的HBeAg血清学清除被随后显著血症和肝炎发作有关。男性的性别和年龄与显著血症有关。

咬牙硬挺

感谢分享，史蒂芬新年快乐！

王震宇

接近我2011年的研究水平了

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