血清乙型肝炎表面抗原和乙型肝炎e抗原水平与慢性乙型肝炎

StephenW

Chin Med J (Engl). 2017 Nov 20;130(22):2697-2702. doi: 10.4103/0366-6999.218000.
Negative Correlation of Serum Hepatitis B Surface Antigen and Hepatitis B e Antigen Levels with the Severity of Liver Inflammation in Treatment-naïve Patients with Chronic Hepatitis B Virus Infection.Zhang L1, Li MH1, Cao WH1, Qi TL1, Lu Y1, Wu SL1, Hao HX1, Shen G1, Liu RY1, Hu LP1, Chang M1, Hua WH2, Song SJ2, Wan G1, Xie Y1.
Author information
1Liver Diseases Center, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.2Clinical Test Center, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.

AbstractBACKGROUND: Estimating the grades of liver inflammation is critical in the determination of antiviral therapy in patients chronically infected with hepatitis B virus (HBV). The aim of this study was to investigate the correlation of serum levels of hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) with the liver inflammation grades in treatment-naïve patients with chronic HBV infection.
METHODS: We retrospectively enrolled 584 treatment-naïve HBeAg-positive patients who underwent liver biopsy in Ditan Hospital from January 2008 to January 2016. Based on the severity of liver inflammation, the patients were divided into minimal, mild, and moderate groups. SPSS software was used for statistical analysis of all relevant data.
RESULTS: The liver histological examinations showed that 324, 194, and 66 patients had minimal, mild, and moderate liver inflammation, respectively. The median age of the three groups was 30, 33, and 38 years, respectively (Χ2 = 26.00, P < 0.001). The median HBsAg levels in minimal, mild, and moderate inflammation groups were 4.40, 4.16, and 3.67 log U/ml, respectively, and the median HBeAg levels in the three groups were 3.12, 2.99, and 1.86 log sample/cutoff, respectively; both antigens tended to decrease as the grade of inflammation increased (Χ2 = 99.68 and Χ2 = 99.23, respectively; both P < 0.001). The cutoff values of receiver operating characteristic curve in the age, HBsAg and HBeAg levels were 36 years, 4.31 log U/ml, and 2.86 log S/CO, respectively, l to distinguish minimal grade and other grades of treatment-naïve HBeAg-positive patients with chronic HBV infection.
CONCLUSIONS: Serum HBsAg and HBeAg quantitation might gradually decrease with aggravated liver inflammation and the corresponding cutoff values might help us to distinguish minimal grades and other grades and detect those who do not need antiviral therapy in treatment-naïve HBeAg-positive patients with chronic HBV infection.


PMID:29133758DOI:10.4103/0366-6999.218000

StephenW

Chin Med J（Engl）。 2017年11月20日; 130（22）：2697-2702。 doi：10.4103 / 0366-6999.218000。
血清乙型肝炎表面抗原和乙型肝炎e抗原水平与慢性乙型肝炎病毒感染治疗初治患者肝炎严重程度的负相关。
张L1，李MH1，曹WH1，齐TL1，陆Y1，吴SL1，郝HX1，沉G1，刘RY1，胡LP1，常M1，华WH2，宋SJ2，万G1，谢Y1。
作者信息

1
    首都医科大学附属北京地坛医院肝病中心，北京100015
2
    首都医科大学附属北京地坛医院临床检验中心，北京100015

抽象
背景：

评估慢性乙型肝炎病毒（HBV）感染患者的肝脏炎症评分是确定抗病毒治疗的关键。本研究旨在探讨乙型肝炎表面抗原（HBsAg）和乙型肝炎e抗原（HBeAg）血清水平与未治疗的慢性HBV感染患者的肝脏炎症分级之间的相关性。
方法：

我们回顾性分析2008年1月至2016年1月在地坛医院接受肝穿刺活检的584例初治HBeAg阳性患者，根据肝脏炎症程度将患者分为轻，中，重度组。使用SPSS软件对所有相关数据进行统计分析。
结果：

肝脏组织学检查显示，324例，194例和66例患者分别有轻度，轻度和中度肝脏炎症。三组的中位年龄分别为30岁，33岁和38岁（X2 = 26.00，P <0.001）。轻中度和中度炎症组HBsAg中位数分别为4.40,4.16和3.67log U / ml，三组中位HBeAg水平分别为3.12,2.99和1.86对数样本/临界值;随着炎症程度的增加，两种抗原趋于下降（Χ2= 99.68，Χ2= 99.23，均P <0.001）。年龄，HBsAg和HBeAg水平的受试者工作特征曲线的临界值分别为36岁，4.31 log U / ml和2.86 log S / CO，分别为最低等级和其他等级的初治HBeAg阳性慢性HBV感染的患者。
结论：

血清HBsAg和HBeAg定量可能随着肝脏炎症加重而逐渐降低，相应的临界值可能有助于我们区分最低等级和其他等级，并检测那些未接受过治疗的HBeAg阳性慢性HBV感染患者不需要抗病毒治疗。

结论：
    29133758
DOI:
    10.4103/0366-6999.218000

antiHBVren

这是那种从来没有治疗的携带者的特征；
即依靠免疫力来抗病毒，最后病毒得到一定的遏制，E抗原和S抗原下降，但是由于免疫力不断参与与病毒的斗争，导致炎症越来越重；

而对于抗病毒的来说，抗病毒替代免疫力，可以让E抗原和S抗原下降，同时由于减少甚至没有免疫力的参与，炎症只会越来越轻；
因而，替诺福韦对早期肝硬化有改善的作用；