定量乙型肝炎表面抗原在HBeAg阴性慢性乙型肝炎患者预测无活

StephenW

Medicine (Baltimore). 2017 Mar;96(13):e6554. doi: 10.1097/MD.0000000000006554.
Role of quantitative hepatitis B surface antigen in predicting inactive carriers and HBsAg seroclearance in HBeAg-negative chronic hepatitis B patients.
Ungtrakul T1, Sriprayoon T, Kusuman P, Chunnuan P, Soonklang K, Sornsamdang G, Auewarakul CU, Tanwandee T.
Author information

1    aChulabhorn Hospital bFaculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Abstract

To evaluate quantitative hepatitis B surface antigen (qHBsAg) as a diagnostic marker for inactive carriers (ICs) and hepatitis B surface antigen (HBsAg) seroclearance in hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) patients. We retrospectively studied 300 HBeAg-negative CHB patients with initial serum hepatitis B virus (HBV) Deoxyribonucleic acid (DNA) levels <2000 IU/mL. Serum HBV DNA and alanine aminotransferase (ALT) levels were monitored every 6 months for 24 months. ICs were identified as having persistent HBV DNA levels <2000 IU/mL and normal ALT levels, whereas active carriers (ACs) were identified as having HBV DNA levels ≥2000 IU/mL, with or without elevated ALT levels. The serum qHBsAg level was defined at baseline and evaluated as a diagnostic predictor using a receiver-operating characteristic curve. The study group comprised 134 men and 166 women with a median age of 41.5 years. At baseline, 200 ICs displayed lower levels of qHBsAg (1492 IU/mL) compared with 100 ACs (2936 IU/mL) (P = 0.005). The qHBsAg level was independently associated with the IC state and HBsAg seroclearance. Baseline qHBsAg levels <1000 IU/mL and HBV DNA levels <2000 IU/mL, when detected simultaneously, allowed for identification of ICs with 41% sensitivity and 72% specificity. Fifteen patients (5%) displayed HBsAg seroclearance after 24 months. A qHBsAg cutoff value of <50 IU/mL provided 100% sensitivity and 92% specificity in predicting HBsAg seroclearance. The qHBsAg level at a single timepoint among HBeAg-negative CHB patients with low HBV DNA levels at baseline was not a predictive marker for ICs; however, it accurately predicted spontaneous HBsAg seroclearance at 24 months.

PMID:
    28353619
DOI:
    10.1097/MD.0000000000006554

StephenW

医学（巴尔的摩）。 2017年3月; 96（13）：e6554。 doi：10.1097 / MD.0000000000006554。
定量乙型肝炎表面抗原在HBeAg阴性慢性乙型肝炎患者预测无活性载体和HBsAg血清白蛋白的作用。
Ungtrakul T1，Sriprayoon T，Kusuman P，Chunnuan P，Soonklang K，Sornsamdang G，Auewarakul CU，Tanwandee T.
作者信息

1
    aChulabhorn医院b泰国曼谷Mahidol大学医学院Siriraj医院。

抽象

评估定量乙型肝炎表面抗原（qHBsAg）作为乙型肝炎e抗原（HBeAg）阴性慢性乙型肝炎（CHB）患者的非活动载体（ICs）和乙型肝炎表面抗原（HBsAg）血清白蛋白的诊断标志物。我们回顾性研究了300例初始血清乙型肝炎病毒（HBV）脱氧核糖核酸（DNA）水平<2000 IU / mL的HBeAg阴性CHB患者。每六个月监测血清HBV DNA和丙氨酸氨基转移酶（ALT）水平24个月。 ICs被鉴定为具有持续的HBV DNA水平<2000IU / mL和正常ALT水平，而活性载体（AC）被鉴定为具有≥2000IU/ mL的HBV DNA水平，具有或不具有升高的ALT水平。血清qHBsAg水平在基线定义，并作为诊断预测因子使用接受者工作特征曲线进行评估。研究组包括134名男性和166名女性，平均年龄为41.5岁。在基线时，与100个AC（2936IU / mL）相比，200个IC显示较低水平的qHBsAg（1492IU / mL）（P = 0.005）。 qHBsAg水平与IC状态和HBsAg血清学独立相关。基线qHBsAg水平<1000 IU / mL和HBV DNA水平<2000 IU / mL，当同时检测时，允许识别具有41％敏感性和72％特异性的IC。 24个月后，15例（5％）HBsAg血清白蛋白显示。 qHBsAg截止值<50IU / mL提供100％敏感性和92％特异性预测HBsAg血清白蛋白。 HBeAg阴性CHB患者基线时HBV DNA水平较低的单个时间点的qHBsAg水平不是ICs的预测指标;然而，它准确预测了24个月时自发性HBsAg血清清除率。

PMID：
    28353619
DOI：
    10.1097 / MD.0000000000006554