AASLD2016[1838]血清乙型肝炎核心相关抗原及表面 抗原水平与肝

StephenW

1838
Serum hepatitis B core-related antigen and surface
antigen levels are correlated with hepatic fibrosis and
inflammatory activity in treatment-naïve chronic hepatitis
B patients
Tetsuya Hosaka1, Fumitaka Suzuki1, Masahiro Kobayashi1,
Shunichiro Fujiyama1, Yusuke Kawamura1, Hitomi Sezaki1, Norio
Akuta1, Yoshiyuki Suzuki1, Satoshi Saitoh1, Yasuji Arase1, Kenji
Ikeda1, Mariko Kobayashi2, Hiromitsu Kumada1; 1Hepatology,
Toranomon Hospital, Tokyo, Japan; 2Research Institute for hepatology,
Toranomon Hospital, Kawasaki, Japan
Background: Serum hepatitis B core-related antigen (HBcrAg)
and surface antigen (HBsAg) have been known as surrogate
markers of intrahepatic covalently closed circular DNA
(cccDNA). It is unclear whether these serum markers have an
impact on histological progression. We examined whether
serum HBcrAg and HBsAg levels would be correlated with fibrosis
stage and inflammatory activity in patients who do not any
anti-viral treatment. Methods: We conducted a cross-sectional
study of 1499 Asian treatment-naïve CHB patients who underwent
liver biopsy. Serum HBcrAg and HBsAg levels around the
biopsy were measured in all patients using commercial assays.
Fibrosis stage and inflammatory activity were assessed according
to Metavir scoring system. We analyzed whether serum
HBcrAg and HBsAg levels would be correlated with histological
findings stratified by HBeAg status. Results: Of 898 HBeAg
positive patients, 335 (37%) patients had F0-1, 252 (28%)
had F2, 174 (19%) had F3, and 137 (15%) had F4 stage. Of
601 HBeAg negative patients, 196 (33%) patients had F0-1,
181 (30%) had F2, 97 (16%) had F3, and 127 (21%) had F4
stage, respectively. Median HBsAg levels were 4.26 log IU/
mL (IQR; 3.81-4.70) in F0-1, 3.91 (IQR; 3.55-4.33) in F2,
3.61 (IQR; 3.30-4.07) in F3, and 3.32 (IQR; 2.94-3.60) in F4
stage, and significant negative correlation between HBsAg levels
and fibrosis stage was observed in HBeAg positive patients
(P trend <0.0001). On the other hand, HBsAg levels were not
correlated with fibrosis in HBeAg negative patients. Regarding
inflammatory activity, significant negative correlation between
HBsAg levels and activity was also observed in HBeAg positive
patients (P trend <0.0001), but not in HBeAg negative patients.
Median HBcrAg levels were 3.8 log U/mL (IQR; <3.0-4.9) in
F0-1, 4.6 (IQR; 3.8-5.6) in F2, 4.7 (IQR; 3.9-6.0) in F3, and
5.1 (IQR; 4.4-5.9) in F4 stage, and significant positive correlation
between HBcrAg levels and fibrosis stage was observed in
HBeAg negative patients (P trend <0.0001), but not in HBeAg
positive patients because HBcrAg levels were above upper
limit of cut-off (6.8 log U/mL) in many HBeAg positive patients.
Regarding activity, median HBcrAg levels were 3.0 log U/
mL (IQR; <3.0-3.5) in A0, 4.3 (IQR; 3.1-5.2) in A1, 5.1 (IQR;
4.3-6.1) in A2-3 grade in HBeAg negative patients (P trend
<0.0001), but no correlation was observed in HBeAg positive
patients. Significant positive correlation between HBcrAg and
activity was also observed in HBeAg negative patients who
had low ALT levels. Conclusion: Treatment-naïve HBeAg negative
patients with high HBcrAg may have high risk of disease
progression.
Disclosures:
Fumitaka Suzuki - Speaking and Teaching: BMS
Yoshiyuki Suzuki - Speaking and Teaching: Bristol-Myers Squibb
Kenji Ikeda - Speaking and Teaching: Eisai company, Dainippon Sumitomo
Pharmaceutical company
Hiromitsu Kumada - Speaking and Teaching: Bristol-Myers Squibb,Pharma International,
MSD, Abbvie, Glaxosmithkline, Gilead Sciences, Diainippon Sumitomo
Pharma
The following people have nothing to disclose: Tetsuya Hosaka, Masahiro
Kobayashi, Shunichiro Fujiyama, Yusuke Kawamura, Hitomi Sezaki, Norio
Akuta, Satoshi Saitoh, Yasuji Arase, Mariko Kobayashi

StephenW

AASLD2016血清乙型肝炎核心相关抗原及表面
抗原水平与肝纤维化相关
血清乙型肝炎核心相关抗原及表面
抗原水平与肝纤维化相关
治疗初期慢性肝炎的炎症活性
B患者
Tetsuya Hosaka1，Fumitaka Suzuki 1，Masahiro Kobayashi1，
Shunichiro Fujiyama1，Yusuke Kawamura1，Hitomi Sezaki1，Norio
Akuta1，Yoshiyuki Suzuki1，Satoshi Saitoh1，Yasuji Arase1，Kenji
Ikeda1，Mariko Kobayashi2，Hiromitsu Kumada1; 1Hepatology，
Toranomon医院，日本东京; 2肝病研究所，
Toranomon Hospital，Kawasaki，Japan
背景：血清乙型肝炎核心相关抗原（HBcrAg）
和表面抗原（HBsAg）已被认为是替代品
肝内共价闭合环状DNA标记
（cccDNA）。目前尚不清楚这些血清标志物是否具有
对组织学进展的影响。我们检查了
血清HBcrAg和HBsAg水平将与纤维化相关
阶段和炎症活动的患者没有任何
抗病毒治疗。方法：我们进行了横断面
研究1499名接受亚洲治疗的初次接受CHB的患者
肝活检。血清HBcrAg和HBsAg水平在周围
使用商业化验在所有患者中测量活检。
纤维化阶段和炎症活性根据
到Metavir评分系统。我们分析血清
HBcrAg和HBsAg水平将与组织学相关
结果按HBeAg状态分层。结果：898 HBeAg
阳性患者，335（37％）患者有F0-1,252（28％）
具有F2，174（19％）具有F3，和137（15％）具有F4期。的
601 HBeAg阴性患者，196例（33％）患者有F0-1，
181（30％）具有F2，97（16％）具有F3，和127（21％）具有F4
阶段。中位HBsAg水平为4.26log IU /
mL（IQR; 3.81-4.70），F0-1中的3.91（IQR; 3.55-4.33）
F3中的3.61（IQR; 3.30-4.07）和F4中的3.32（IQR; 2.94-3.60）
阶段，和HBsAg水平之间显着负相关
并在HBeAg阳性患者中观察到纤维化分期
（P趋势<0.0001）。另一方面，HBsAg水平不是
与HBeAg阴性患者的纤维化相关。关于
炎症活性，显着负相关
在HBeAg阳性中也观察到HBsAg水平和活性
患者（P趋势<0.0001），但不是HBeAg阴性患者。
中位HBcrAg水平为3.8logU / mL（IQR; <3.0-4.9）in
F2中的F0-1,4.6（IQR; 3.8-5.6），F3中的4.7（IQR; 3.9-6.0）
5.1（IQR; 4.4-5.9）在F4阶段，与显着正相关
之间HBcrAg水平和纤维化阶段
HBeAg阴性患者（P趋势<0.0001），但不在HBeAg中
阳性患者，因为HBcrAg水平高于上
许多HBeAg阳性患者的临界值（6.8 log U / mL）。
关于活性，中值HBcrAg水平为3.0log U /
mL（IQR; <3.0-3.5），在A1中为4.3（IQR; 3.1-5.2），5.1（IQR;
4.3-6.1）在A2-3级HBeAg阴性患者（P趋势
<0.0001），但在HBeAg阳性中未观察到相关性
耐心。 HBcrAg和
活性也在HBeAg阴性患者中观察到
具有低ALT水平。结论：初治HBeAg阴性
患有高HBcrAg的患者可能具有高的疾病风险
进展。
披露：
铃木 - 讲话和教学：BMS
铃木 - 铃木 - 讲话和教学：布里斯托尔 - 迈尔斯
池田池二 - 讲座和教学：Eisai公司，Dainippon住友
制药公司
Hiromitsu Kumada - 讲话和教学：Bristol-Myers Squibb，Pharma International，
MSD，Abbvie，Glaxosmithkline，Gilead Sciences，Diainippon Sumitomo
制药
以下人士没有透露：Tetsuya Hosaka，Masahiro
Kobayashi，Shichiroiro Fujiyama，Yusuke Kawamura，Hitomi Sezaki，Norio
Akuta，Satoshi Saitoh，Yasuji Arase，Mariko Kobayashi

MP4

没有虎之门就没有孙正义，没有孙正义就有马云，没有马云就没双十一