乙肝表面抗原和DNA的血清水平能预测非活动性携带者与疾病

StephenW

Serum Levels of Hepatitis B Surface Antigen and DNA Can Predict Inactive Carriers With Low Risk of Disease Progression
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    First published: 15 April 2016Full publication history
    DOI: 10.1002/hep.28552View/save citation
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    Potential conflict of interest: Richard Batrla-Utermann is an employee of Roche Diagnostics.

    This study was supported by the Taiwan Department of Health, Bristol-Myers Squibb, Roche Diagnostics, and Academia Sinica.

Abstract

Serum levels of hepatitis B virus (HBV) DNA (≤2000 IU/mL) and hepatitis B surface antigen (HBsAg) (<1000 IU/mL) have been shown to distinguish inactive carriers with high accuracy. The goal of this study was to validate the predictability of one-time measurement of quantitative HBsAg and HBV DNA levels for inactive carrier status and chronic hepatitis B (CHB) progression in a community-based cohort. This study included 1529 participants chronically infected with HBV genotype B or C from the REVEAL-HBV cohort. They were ascertained as inactive or active CHB after 18 months of follow-up. Validity of the one-time measurement was assessed by sensitivity, specificity, and receiver operating characteristic curves, while associations with clinical outcomes were calculated with Cox proportional hazards regressions. The one-time baseline measurement of HBsAg <1000 IU/mL and HBV DNA <2000 IU/mL distinguished inactive carriers from active CHB with a sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of 71%, 85%, 83%, 74%, and 78%, respectively. Those identified as inactive carriers using the one-time baseline measurement had multivariate adjusted hazard ratios of 0.36 (95% confidence interval [CI], 0.20-0.63) and 0.36 (0.23-0.56) for hepatocellular carcinoma and liver cirrhosis, respectively, and an adjusted rate ratio of 6.97 (95% CI, 5.21-9.33) for HBsAg seroclearance. Areas under the receiver operating characteristic curve of predicting these outcomes using the one-time definition were similar to those obtained when using long-term follow-up defined carrier status for prediction. Conclusion: This study confirms the predictability of a one-time combined HBsAg and HBV DNA measurement for future inactive carriers. This single-point strategy provides new and complementary information useful for management of patients with chronic hepatitis B infection. (Hepatology 2016;64:381-389)

StephenW

乙肝表面抗原和DNA的血清水平能预测非活动性携带者与疾病进展的低风险
作者

    首先公布：4月15日公布2016Full历史
    ：10.1002 / hep.28552View /保存引文
    引述：0物品检查新引文
    文章为1的比分altmetric

    潜在的利益冲突：理查德Batrla-Utermann是罗氏诊断的员工。

    这项研究是由健康的台系，施贵宝，罗氏诊断和中央研究院的支持。

抽象

乙型肝炎病毒（HBV）DNA（≤2000国际单位/毫升）和B型肝炎表面抗原（HBsAg）（<1000国际单位/毫升）的血清水平已显示出区分非活性载体以高的精度。本研究的目的是为了验证定量HBsAg和HBV DNA水平对以社区为基础的队列非活性载体状态和慢性乙型肝炎（CHB）的进展的一次测量的可预测性。这项研究包括1529参与者慢性感染HBV基因型B或C从REVEAL-HBV队列。他们18个月的随访后认定为无效或有效CHB。一次性测定的有效性是由敏感性，特异性，和受试者工作特性曲线评估，同时与临床结果的关联用Cox比例风险回归计算。 HBsAg的<1000国际单位/毫升和HBV DNA的一次性基线测量<2000国际单位/毫升区分非活动载波从活动CHB具有敏感性，特异性，阳性预测值，阴性预测值，和71％的诊断准确性，85％ ，83％，74％，和78％。那些确定为使用一次性基线测量过0.36（95％置信区间[CI]，0.20-0.63）和0.36（0.23-0.56）的分别为肝细胞癌和肝硬化，多元调整风险比无活性的载体，和一个6.97调整后的速度比（95％CI，5.21-9.33）乙肝表面抗原血清学清除。接受者操作使用一次性定义预测这些结果的特性曲线下的区域中使用所定义的载体状态为预测长期随访时类似于获得的那些。结论：该研究证实一次性结合的HBsAg和HBV DNA测定以供将来不活动载波的可预测性。这种单点战略为慢性乙肝感染管理有用的新和补充信息。 （2016年肝病; 64：381-389）