北美慢性HBV携带者的长期随访和定量乙肝表面抗原监测

StephenW

Ann Hepatol. 2018 Mar 1;17(2):232-241. doi: 10.5604/01.3001.0010.8640.
Long-Term Follow-up and Quantitative Hepatitis B Surface Antigen Monitoring in North American Chronic HBV Carriers.O'Neil CR1, Congly SE2, Rose MS3, Lee SS2, Borman MA2, Charlton CL4, Osiowy C5, Swain MG2, Burak KW2, Coffin CS6.
Author information
1Division of Infectious Disease, Faculty of Medicine & Dentistry University of Alberta, Edmonton, Alberta, Canada.2University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada. Calgary Liver Unit, Division of Gastroenterology and Hepatology.3Research Facilitation, Alberta Health Services, Calgary, Alberta, Canada.4University of Alberta, Edmonton, Alberta, Canada. Provincial Laboratory for Public Health, Edmonton, Alberta, Canada. Department of Laboratory Medicine and Pathology.5National Microbiology Laboratory, Winnipeg, Manitoba, Canada.6Calgary Liver Unit, Division of Gastroenterology and Hepatology, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.

AbstractINTRODUCTION: Quantitative hepatitis B surface antigen (qHBsAg) combined with HBV DNA may be useful for predicting chronic hepatitis B (CHB) activity and nucleoside analogue (NA) response.
MATERIAL AND METHODS: In this retrospective cohort study we evaluated qHBsAg levels according to CHB disease phase and among patients on treatment. Random effect logistic regression analysis was used to analyze qHBsAg change with time in the NA-treated cohort.
RESULTS: 545 CHB carriers [56% M, median age 48 y (IQR 38-59), 73% Asian] had qHBsAg testing. In the untreated group (44%), 8% were classified as immune tolerant, 10% immune clearance, 40% inactive, and 43% had HBeAg- CHB and the median HBsAg levels were 4.6 (IQR 3.4-4.9), 4.0 (IQR 3.4-4.5), 2.9 (IQR 1.4-3.8), and 3.2 log IU/mL (IQR 2.6-4.0), respectively; p < 0.001. In the NA-treated group (28% entecavir, 68% tenofovir, 4% lamivudine), no significant change in qHBsAg levels occurred with time, 19% of patients on long-term NA had sustained qHBsAg < 2 log10 IU/mL.
CONCLUSION: qHBsAg titers were associated with CHB phase and remained stable in those on long-term NA. A significant number of treated patients had low-level qHBsAg, of which some may be eligible for treatment discontinuation without risk of flare.


KEYWORDS: Chronic Hepatitis B. Natural History. Disease Phase. Nucleoside Analogues. Diagnostic Test. Canada.

PMID:29469040DOI:10.5604/01.3001.0010.8640

StephenW

安Hepatol。 2018年3月1日; 17（2）：232-241。 doi：10.5604 / 01.3001.0010.8640。
北美慢性HBV携带者的长期随访和定量乙肝表面抗原监测。
O'Neil CR1，Congly SE2，Rose MS3，Lee SS2，Borman MA2，Charlton CL4，Osiowy C5，Swain MG2，Burak KW2，Coffin CS6。
作者信息

1
    加拿大艾伯塔省埃德蒙顿艾伯塔大学医学和牙科学院传染病学系。
2
    卡尔加里大学卡明医学院，加拿大艾伯塔卡尔加里。卡尔加里肝脏单位，胃肠病学和肝病学分部。
3
    研究促进，艾伯塔卫生服务，加拿大艾伯塔卡尔加里。
4
    加拿大艾伯塔省埃德蒙顿艾伯塔大学。加拿大艾伯塔省埃德蒙顿省公共卫生省级实验室。检验医学和病理学系。
五
    加拿大马尼托巴温尼伯国家微生物实验室。
6
    Calgary Liver Unit，卡尔加里卡明大学医学院胃肠病学和肝病学系，加拿大艾伯塔卡尔加里。

抽象
介绍：

定量乙肝表面抗原（qHBsAg）联合HBV DNA可能有助于预测慢性乙型肝炎（CHB）活动和核苷类似物（NA）反应。
材料与方法：

在这项回顾性队列研究中，我们根据CHB疾病阶段和治疗中的患者评估qHBsAg水平。随机效应logistic回归分析用于分析NA治疗组中qHBsAg随时间的变化。
结果：

qHBsAg检测545名CHB携带者[56％M，平均年龄48岁（IQR 38-59），73％亚洲人]。在未治疗组（44％）中，8％被列为免疫耐受，10％免疫清除率，40％无活性，43％有HBeAg-CHB，中位HBsAg水平分别为4.6（IQR 3.4-4.9），4.0 3.4-4.5），2.9（IQR 1.4-3.8）和3.2log IU / mL（IQR 2.6-4.0）; p < 0.001。在NA治疗组（28％恩替卡韦，68％替诺福韦，4％拉米夫定）中，qHBsAg水平随时间没有显着变化，19％的患者长期NA持续qHBsAg < 2log10IU / mL。
结论：

qHBsAg滴度与CHB期相关，并且在长期NA患者中保持稳定。相当数量的治疗患者有低水平的qHBsAg，其中一些可能有资格停止治疗而没有发生眩晕风险。
关键词：

慢性乙型肝炎自然史。疾病阶段。核苷类似物。诊断测试。加拿大。

结论：
    29469040
DOI：
    10.5604 / 01.3001.0010.8640