重新评价的HBsAg血清清除的：高度敏感乙肝表面抗原水平的纵

StephenW

Liver Int. 2015 Oct 16. doi: 10.1111/liv.12980. [Epub ahead of print]
Longitudinal profiles of highly-sensitive hepatitis B surface antigen levels: re-evaluation of HBsAg seroclearance.Seto WK1,2, Tanaka Y3, Wong DK1,2, Shinkai N3, Cheung KS1, Liu KS1, Fung J1,2, Lai CL1,2, Yuen MF1,2.
Author information

• 1Department of Medicine, the University of Hong Kong, Queen Mary Hospital, Hong Kong.
• 2State Key Laboratory for Liver Research, the University of Hong Kong, Queen Mary Hospital, Hong Kong.
• 3Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
  

AbstractBACKGROUND: Serologic profiles after hepatitis B surface antigen (HBsAg) seroclearance in chronic hepatitis B (CHB) have not been well-studied.
METHODS: We employed a highly-sensitive HBsAg (hs-HBsAg) assay (lower detection limit 0.5 mIU/mL), 100 times more sensitive than conventional HBsAg measurements. CHB patients achieving HBsAg seroclearance defined by conventional assays were followed up for serum hs-HBsAg, HBV DNA and antibody to HBsAg (anti-HBs) levels at 0 months, 6-12 months and 3-5 years after HBsAg seroclearance. Factors associated with hs-HBsAg detectability were determined.
RESULTS: 109 patients were recruited; 94 (86.2%) were followed up to years 3-5; and 25 patients (22.9%) were on nucleoside analogue therapy for a median duration of 6.0 (range 1.5-12.7) years before HBsAg seroclearance. Detectable hs-HBsAg was noted in 88 (80.7%), 60 (55.0%) and 20 (21.3%) patients at 0 months, 6-12 months and 3-5 years respectively. At years 3-5, genotype B patients, when compared to genotype C patients, had a higher anti-HBs positive rate (63.2% and 41.1% respectively, p=0.036). Serum anti-HBs positivity, when compared to persistent anti-HBs negativity, was associated with a lower rate of hs-HBsAg detection (7.4% and 40% respectively, p<0.001). Multivariate analysis showed anti-HBs negativity at years 3-5 to be independently associated with persistently positive hs-HBsAg (p=0.007, odds ratio 7.1, 95% confidence interval 1.7-29.3).
CONCLUSION: Serum hs-HBsAg could detect HBsAg presence in a substantial proportion of CHB after HBsAg seroclearance defined by conventional assays, especially among anti-HBs negative individuals. Serum hs-HBsAg could potentially assist differentiating HBsAg-negative CHB from individuals with only past HBV exposure without carrier state. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.


KEYWORDS: HBV; HBsAg; anti-HBc; anti-HBs; hs-HBsAg

StephenW

肝诠释。 2015年十月16 DOI：10.1111 / liv.12980。 [打印EPUB提前]
重新评价的HBsAg血清清除的：高度敏感乙肝表面抗原水平的纵向型材。
濑户WK1,2，田中Y3，黄DK1,2，新海N3，长KS1，刘KS1，凤J1,2，赖CL1,2，玄MF1,2。
作者信息

    香港大学玛丽医院，香港教研室医学。
    香港大学国家重点实验室为肝脏研究，玛丽医院，香港。
    3Department病毒学和肝单位，医学科学名古屋市立大学研究生院，日本名古屋。

抽象的
背景：

乙型肝炎表面抗原（HBsAg）血清清除慢性乙型肝炎（CHB）后血清学概况没有得到充分研究。
方法：

我们采用了一种高灵敏度的HBsAg（HS-HBsAg的）测定（检测下限0.5 MIU /毫升），100倍，比传统的HBsAg测量更敏感。慢性乙肝患者获得常规检测乙肝表面抗原定义转阴，随访血清HS-乙肝表面抗原，乙肝病毒DNA和抗体对HBsAg（抗-HBs）在0个月，6-12个月，乙肝表面抗原血清学清除经过3-5年的水平。与HS-乙肝表面抗原检测能力有关的因素进行了测定。
结果：

109例患者被招募; 94（86.2％），随访至年3-5;和25例（22.9％）是在核苷类似物治疗的6.0（范围1.5-12.7）年的HBsAg血清清除前的中值持续时间。可检测的HS-HBsAg的在0个月，6-12个月和3 - 5年分别指出，在88（80.7％），60（55.0％）和20（21.3％）的患者。在年3-5，B基因型的患者，相对于C基因型的患者，有较高的抗-HBs阳性率（分别为63.2％和41.1％，P = 0.036）。血清抗HBs阳性，相对于持久抗-HBs消极，用HS-HBsAg的检测的较低速率相关（分别为7.4％和40％，p值<0.001）。多变量分析，在年3-5表明可以独立地被持续阳性HS-的HBsAg相关抗HBs阴性（p值= 0.007，比值比7.1，95％置信区间1.7-29.3）。
结论：

血清HS-乙肝表面抗原可以检测乙肝表面抗原存在慢性乙型肝炎的常规检测乙肝表面抗原定义转阴后，相当大的比例，尤其是抗HBs阴性个体。血清HS-乙肝表面抗原可能有助于区分HBsAg阴性CHB个人，只有过去的乙肝病毒暴露不带菌状态。这篇文章是受版权保护的。版权所有。

这篇文章是受版权保护的。版权所有。
关键词：

乙肝病毒;乙肝表面抗原;抗HBc;抗-HBs; HS-乙肝表面抗原