[AASLD](1555)并发HBsAg和抗-HBs乙患者患病率和慢性肝炎血清学特

StephenW

1555
Prevalence and serological features of chronic hepatitis
B patients with concurrent HBsAg and anti-HBs in the
Hepatitis B Research Network (HBRN).
William M. Lee1, Yona K. Cloonan2, Kathleen B. Schwarz3, Doan
Y. Dao1, Anna S. Lok4; 1Division of Digestive and Liver Diseases,
University of Texas Southwestern Medical Center at Dallas, Dallas,
TX; 2Epidemiology, University of Pittsburgh, Pittsburgh, PA; 3Pediatrics,
Johns Hopkins University School of Medicine, Baltimore, MD;
4Gastroenterology, University of Michigan, Ann Arbor, MI
Background: Some patients with chronic HBV infection have
concurrent HBsAg and anti-HBs. We examined the HBRN
cohort to determine the prevalence of anti-HBs in participants
with chronic HBV infection, and compared demographic and
clinical factors between participants with and without anti-HBs.
Methods: Data from 1402 (1115 adults and 287 pediatric)
participants with chronic HBV infection enrolled in the HBRN,
who had been tested for both HBsAg and anti-HBs within 1
year of enrollment were included. 139 participants belonging
to specifically targeted groups (e.g., pregnant women) were
excluded from prevalence estimates. Characteristics of anti-HBs
positive and anti-HBs negative participants were compared.
Results: 93 participants were anti-HBs positive, overall prevalence
of concurrent HBsAg and anti-HBs was 6.6% (7.7%
pediatric and 6.3% adult). Age, sex, race and birthplace did
not differ significantly between anti-HBs positive and anti-HBs
negative participants. Similarly, there were no significant differences
in mode of transmission, estimated years of infection,
past HBV treatment, prevalence of HBeAg, HBV genotypes,
AST, ALT or other biochemical markers of liver injury[SB1] in
the 2 groups. HBsAg levels were significantly lower in anti-HBs
positive participants: median 3.0 vs. 3.6 log10 IU/mL (p<0.01)
while HBV DNA levels were similar: median 4.9 vs. 4.5 log10
IU/mL. Similar patterns for HBsAg and HBV DNA levels were
noted in pediatric and adult groups. Conclusion: Concurrent
HBsAg and anti-HBs is not uncommon in persons with chronic
HBV infection. The prevalence of anti-HBs is similar for adults
and children, and is not associated with markers of disease
activity or a specific clinical phenotype. Anti-HBs positive participants
had lower HBsAg titers but similar HBV DNA levels
suggesting a role for anti-HBs in decreasing sub-virion particles
or in immune control of HBV infection. Further studies are
planned to examine surface gene variants and anti-HBs titers in
this [SB2] population.

StephenW

1555
患病率和慢性肝炎血清学特性
乙患者并发HBsAg和抗-HBs在
乙型肝炎研究网络（HBRN）。
威廉·M Lee1，约纳K. Cloonan2，凯瑟琳B. Schwarz3，杜安
Y. Dao1，安娜S. Lok4;消化和肝病1区，
得克萨斯大学西南医学中心在达拉斯，小牛，
TX; 2Epidemiology，匹兹堡，匹兹堡，宾夕法尼亚大学， 3Pediatrics，
约翰斯·霍普金斯大学医学院，巴尔的摩，医学博士;
4Gastroenterology，密歇根大学，密歇根州安阿伯
背景：有些慢性乙肝病毒感染有
并发HBsAg和抗-HBs。我们检查了HBRN
队列，以确定抗-HBs的参与者的患病率
慢性HBV感染，并比较人口和
参与者有和没有抗HBs的临床因素。
方法：数据来自1402（1115名成人和287小儿）
与会者慢性HBV感染者参加了HBRN，
谁已测试HBsAg和内1抗HBs
被列入招生一年。属于139参与者
具体目标群体（如孕妇）分别为
排除患病率估计。抗-HBs的特点
阳性和抗-HBs阴性参与者进行比较。
结果：93参加者抗-HBs阳性，总体患病
并发HBsAg和抗-HBs为6.6％（7.7％
儿童和6.3％的成年）。年龄，性别，种族和出生地做
不抗-HBs阳性，抗-HBs之间显著差异
消极的参与者。同样，没有显著差异
在传输模式，估计年感染，
过去的乙肝治疗中，HBeAg和HBV基因型患病率，
AST，ALT或肝损伤[SB1]在其他的生化标志物
的2组。 HBsAg的水平在显著降低抗HBs
积极参与者：中位数3.0与3.6日志10 IU /毫升（P <0.01）
而HBV DNA水平相似：平均4.9与4.5 LOG10
国际单位/毫升。类似的模式HBsAg和HBV DNA水平
在儿童和成人组指出。结论：并发
HBsAg和抗-HBs并不少见，慢性者
HBV感染。抗-HBs的流行是类似成人
和儿童，并且不与疾病标志物相关的
活性或一个特殊的临床表型。抗-HBs阳性的参与者
有较低的HBsAg滴度但类似的HBV DNA水平
这提示抗HBs在降低子病毒颗粒作用
或HBV感染的免疫控制。进一步的研究是
计划研究表层的基因变异体和抗-HBs滴度
这[SB2]人口。