血清乙型肝炎病毒核心相关抗原作为聚乙二醇干扰素的患者

StephenW

Viral Hepatitis
Serum hepatitis B core-related antigen as a treatment predictor of pegylated interferon in patients with HBeAg-positive chronic hepatitis B

    Natthaya Chuaypen1, Nawarat Posuwan2, Sunchai Payungporn1, Yasuhito Tanaka3, Noboru Shinkai3, Yong Poovorawan2 andPisit Tangkijvanich1,*

    1    Research Unit of Hepatitis and Liver Cancer, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
    2    Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
    3    Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

* Correspondence

Version of Record online: 5 JAN 2016

DOI: 10.1111/liv.13046

© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Issue
Liver International


Volume 36, Issue 6, pages 827–836, June 2016
Article has an altmetric score of 1


Keywords:

    HBsAg quantification;hepatitis B core-related antigen;hepatitis B virus;pegylated interferon

Abstract
Background & Aims

The role of quantitative serum hepatitis B core-related antigen (HBcrAg) in patients with chronic hepatitis B (CHB) receiving pegylated interferon (PEG-IFN) is unclear. This study was aimed at comparing its usefulness with quantitative HBsAg in patients with HBeAg-positive CHB receiving PEG-IFN therapy.
Methods

A total 46 patients treated with PEG-IFN for 48 weeks were retrospectively analysed. Intrahepatic covalently closed circular DNA (cccDNA) from paired liver biopsies and serial serum HBsAg and HBcrAg during therapy were assessed.
Results

Virological response (VR), defined as HBeAg clearance and HBV DNA <2000 IU/ml at 24 weeks post treatment, was achieved in 15 (32.6%) patients. Responders had significantly higher cccDNA decline from baseline compared with non-responders. Baseline HBsAg and HBcrAg were correlated with cccDNA (r = 0.424, P = 0.020 and r = 0.564, P = 0.001, respectively), and changes in the corresponding markers during therapy were correlated with cccDNA reduction (r = 0.579, P = 0.001 and r = 0.503, P = 0.005, respectively). Responders showed more rapid decline of both markers during therapy compared with non-responders. In multivariate analysis, serum HBcrAg at week 12 was identified as a predictor of VR. The optimal cut-off value for HBcrAg (log10 8.0 U/ml) provided negative predictive value (NPV) of achieving VR at weeks 12 and 24 of 94.4 and 100%, respectively, while using HBsAg > 20 000 IU/ml provided NPV of 80 and 100% respectively.
Conclusions

The convenient quantitative HBcrAg represented a reliable marker of intrahepatic cccDNA. Monitoring HBcrAg levels during PEG-IFN therapy may help identify patients with a very low probability of response comparable to, if not better than, quantitative HBsAg.

StephenW

病毒性肝炎
血清乙型肝炎病毒核心相关抗原作为聚乙二醇干扰素的患者治疗的预测HBeAg阳性慢性乙型肝炎

    Natthaya Chuaypen1，Nawarat酒店Posuwan2，Sunchai Payungporn1，保仁Tanaka3，升Shinkai3，勇Poovorawan2 andPisit Tangkijvanich1，*

    朱拉隆功大学肝炎1研究组和肝癌，医学系，曼谷，泰国
    朱拉隆功大学卓越2中心临床病毒学杂志，医学系，曼谷，泰国
    病毒学和肝单位，医学科学名古屋市立大学研究生院，名古屋，日本的3系

*通讯

2016年1月5日：记录在线版本

DOI：10.1111 / liv.13046

2015年©约翰·威利父子A / S。由John Wiley＆Sons出版有限公司

问题
肝国际


第36卷，第6期，页827-836，2016年6月
文章为1的比分altmetric


关键词：

    乙肝表面抗原定量;乙型肝炎核心相关抗原，乙肝病毒;聚乙二醇化干扰素

抽象
背景和目的

定量血清乙型肝炎核心相关抗原的慢性乙型肝炎（CHB）接收聚乙二醇化的干扰素（PEG-IFN）的作用（HBcrAg）尚不清楚。本研究旨在例HBeAg阳性CHB接受PEG-IFN治疗其实用性与乙肝表面抗原定量比较。
方法

用PEG-IFN治疗48周，共有46例患者进行回顾分析。从配对肝活检和治疗期间的串行血清HBsAg和HBcrAg肝内共价闭合环状DNA（cccDNA的）进行了评估。
结果

病毒学应答（VR），其定义为HBeAg清除和HBV DNA <2000国际单位/毫升在24周处理后，在15（32.6％）的患者达到了。应答者从基线显著较高的cccDNA的下降与非应答者相比。基线HBsAg和HBcrAg与cccDNA的进行相关（r = 0.424，P = 0.020且r = 0.564，P = 0.001），并在治疗期间的相应标记的变化与cccDNA的减少被相关（r = 0.579，P = 0.001和R = 0.503，P = 0.005，分别）。应答者无应答者相比，治疗过程中表现出两种标记的快速下降。多变量分析显示，在第12周的血清HBcrAg被认定为VR的预测。对于HBcrAg最佳截止值（log10的8.0 U / ml）的提供实现在周12 VR和分别为94.4和100％，24阴性预测值（NPV），同时使用的乙肝表面抗原> 20 000 IU / ml的提供NPV分别为80和100％。
结论

方便的定量HBcrAg代表肝内cccDNA的可靠指标。 PEG-IFN治疗期间监控HBcrAg水平可能有助于确定患者媲美响应的概率非常低，如果不超过，定量的HBsAg要好。