使用生化和血清学标记测定乙型肝炎表型。

StephenW

J Viral Hepat. 2016 Dec 5. doi: 10.1111/jvh.12643. [Epub ahead of print]
Determination of hepatitis B phenotype using biochemical and serological markers.Di Bisceglie AM1, Lombardero M2, Teckman J1, Roberts L3, Janssen HL4, Belle SH2, Hoofnagle JH5; Hepatitis B Research Network (HBRN).
Collaborators  (35)

Author information

• 1Saint Louis University Liver Center, St. Louis, MO, USA.
• 2University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.
• 3Mayo Clinic Foundation, Rochester, MN, USA.
• 4University of Toronto and Erasmus MC University Hospital Rotterdam, Rotterdam, Zuid-Holland, The Netherlands.
• 5Liver Disease Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Bethesda, MD, USA.
  

AbstractThe aim of this study was to assess the validity of categorization of chronic hepatitis B viral infection into stages or phases based upon measures of disease activity and viral load, assuming these phenotypes will be useful for prognostication and determining the need for antiviral therapy. We assessed the phenotype of hepatitis B of 1,390 adult participants enrolled in the Hepatitis B Research Network Cohort Study, using a computer algorithm. Only 4% were immune tolerant, while 35% had chronic hepatitis B (18% e antigen positive and 17% e antigen negative) while 23% were inactive carriers. Strikingly, 38% of participants did not fit clearly into any one of these groups and were considered indeterminant. The largest subset of indeterminants had elevated serum aminotransferases with low levels of HBV DNA (less than 10,000 iu/mL). Subsequent determination of hepatitis B phenotype on the next available laboratory tests showed that 64% remained indeterminant. These findings call into question the validity of conventional staging of hepatitis B, in large part because of the substantial proportion of patients who do not fit readily into one of the usual stages or phases. Further studies are needed of the indeterminant category of chronic hepatitis B viral infection, including assessments of whether patients in this group are perhaps in transition to another phase or if they are a distinct phenotype with a need to assess liver disease severity and need for antiviral therapy. (ClinicalTrials.gov identifier NCT01263587).

© 2016 John Wiley & Sons Ltd.

KEYWORDS: algorithm; hepatitis B; phases; phenotype; stages

PMID:27917600DOI:10.1111/jvh.12643

StephenW

J病毒Hepat。 2016 Dec 5. doi：10.1111 / jvh.12643。 [打印前的电子版]
使用生化和血清学标记测定乙型肝炎表型。
Di Bisceglie AM1，Lombardero M2，Teckman J1，Roberts L3，Janssen HL4，Belle SH2，Hoofnagle JH5;乙型肝炎研究网络（HBRN）。
合作者（35）
作者信息

    1圣路易斯大学肝脏中心，圣路易斯，密苏里州，美国。
    2匹兹堡大学公共卫生研究生院，匹兹堡，PA，美国。
    3Mayo Clinic Foundation，Rochester，MN，USA。
    4多伦多大学和伊拉斯姆斯MC大学医院鹿特丹，鹿特丹，荷兰荷兰，荷兰。
    5 Liver Disease Research Branch，National Institute of Diabetes and Digestive and Kidney Diseases（NIDDK），Bethesda，MD，USA。

抽象

本研究的目的是基于疾病活动和病毒载量的测量，评估慢性乙型肝炎病毒感染分类为阶段或阶段的有效性，假设这些表型将有助于预后和确定抗病毒治疗的需要。我们使用计算机算法评估了参与乙型肝炎研究网络队列研究的1390名成年受试者的乙型肝炎的表型。只有4％是免疫耐受的，而35％患有慢性乙型肝炎（18％e抗原阳性和17％e抗原阴性），而23％是不活动载体。引人注目的是，38％的参与者不能清楚地适应这些组中的任何一个，并且被认为是不确定的。最大的不确定因子亚型具有升高的血清氨基转移酶和低水平的HBV DNA（小于10,000 iu / mL）。随后在接下来可用的实验室测试中测定乙型肝炎表型，显示64％仍然是不确定的。这些发现引起对常规分期的乙型肝炎的有效性的质疑，在很大程度上是因为相当大比例的患者不适合容易地进入通常的阶段或阶段之一。需要对慢性乙型肝炎病毒感染的不确定类别进行进一步研究，包括评估该组中的患者是否可能转变为另一期，或者如果它们是需要评估肝病严重性和抗病毒治疗需要的不同表型。 （ClinicalTrials.gov标识符NCT01263587）。

©2016 John Wiley＆Sons Ltd.
关键词：

算法;乙型肝炎;相;表型;阶段

PMID：
    27917600
DOI：
    10.1111 / jvh.12643