HBV表面蛋白比率预测无活性的载体阶段

StephenW

HBV surface protein ratios predict inactive carrier phase

Pfefferkorn M, et al. Gut. 2018;doi:10.1136/gutjnl-2017-313811.
March 28, 2018

Lower ratios of hepatitis B middle surface proteins and large surface proteins predicted the inactive HBV carrier phase better than total HBV surface antigen, according to recently published data.

“Differentiating between patients being in a stable inactive ‘carrier’ state as compared with those with disease activity or risk of disease reactivation (the [inactive carrier] and active phases of HBV infections) is of paramount importance in clinical practice,” Maria Pfefferkorn, MD, from the University Hospital Leipzig, Germany, and colleagues wrote.

Pfefferkorn and colleagues enrolled 183 patients with HBV to determine whether the composition of HBsAg improved the identification of inactive carriers among HBsAg-positive participants with different phases of HBV infections.

The researchers classified patients into early acute phase (n = 14), HBV e antigen-negative chronic infection or inactive carrier phase (n = 44), HBeAg-negative chronic hepatitis (n = 46), HBeAg-positive phase (n = 68) or coinfected with hepatitis D (n = 11).

Patients in the inactive carrier phase had significantly lower quantities and mean ratios of middle surface proteins (MHB) and large surface proteins (LHB) compared with the other groups (P < .0001) and significantly higher ratios of small surface proteins (SHBs) compared with the other groups (P < .0001). Patients coinfected with HDV had the highest ratios of MHBs and LHBs (P < .0001).

Inactive carriers and patients in the HBeAg-negative chronic HBV phases had identical HBsAg levels. However, inactive carriers had significantly lower mean ratios of MHBs (2 vs. 4.7; P = .0045) and LHBs (1.8 vs. 5.7; P = 8.16 × 10–13) compared with patients in the HBeAg-negative chronic HBV phases.

Final analysis showed that the greatest predictors for inactive carrier phase was the ratio of LHBs (AUROC = 0.89; P = 2.18 × 10–9), followed by the ratio of MHBs (AUROC = 0.73; P = .00114) and total HBsAg (AUROC = 0.62; P = .04322). HBV DNA levels also strongly predicted inactive carrier phase (AUROC = 0.98; P = 2.8 × 10–13).

“We showed that the composition of HBsAg was distinct in the different phases of hepatitis B and that the ratio of the different components of HBsAg in a ‘real-life’ cohort was a better predictor of the [inactive carrier] phase than serum HBV DNA or total HBsAg levels,” the researchers concluded. “We suggest that the ratios of LHBs and MHBs may be more useful markers than total HBsAg levels for differentiating between inactive and active forms of [chronic HBV].” – by Talitha Bennett

Disclosure: The authors report no relevant financial disclosures.

StephenW

HBV表面蛋白比率预测无活性的载体阶段

Pfefferkorn M等人肠道。 2018; DOI：10.1136 / gutjnl-2017-313811。
2018年3月28日

根据最近公布的数据，较低比例的乙肝中表面蛋白和大表面蛋白预测不活动的HBV携带者阶段比总HBV表面抗原更好。

“在临床实践中，区分处于稳定非活动”携带者“状态的患者与具有疾病活动或疾病再活化风险的患者（[无活性携带者]和HBV感染的活动期）是极其重要的，”Maria Pfefferkorn，医学博士，德国莱比锡大学医院及其同事写道。

Pfefferkorn及其同事招募了183名HBV感染患者，以确定HBsAg的组成是否改善了HBV感染不同阶段的HBsAg阳性参与者中非活动性携带者的鉴定。

研究人员将患者分为早期急性期（n = 14），HBV e抗原阴性慢性感染或无活动期携带期（n = 44），HBeAg阴性慢性肝炎（n = 46），HBeAg阳性期（n = 68） ）或合并D型肝炎（11例）。

与其他组相比，非活动载体阶段的患者的中量表面蛋白（MHB）和大表面蛋白（LHB）的数量和平均比率显着较低（P <0.0001），并且显着更高比率的小表面蛋白（SHB）与其他组（P <.0001）。与HDV共同感染的患者具有最高的MHB和LHB比率（P <.0001）。

HBeAg阴性慢性HBV阶段中的非活动载体和患者具有相同的HBsAg水平。然而，与HBeAg阴性的慢性HBV期患者相比，非活动性携带者的MHB平均比值（2比4.7; P = 0.0045）和LHBs（1.8比5.7; P = 8.16×10-13）显着降低。

最终分析表明，非活动载体阶段的最大预测因子是LHBs（AUROC = 0.89; P = 2.18×10-9），其次是MHBs（AUROC = 0.73; P = 0.00114）和总HBsAg AUROC = 0.62; P = 0.04322）。 HBV DNA水平也强烈预测无活性的载体阶段（AUROC = 0.98; P = 2.8×10-13）。

“我们发现HBsAg的组成在乙型肝炎的不同阶段是不同的，并且”现实生活“队列中HBsAg不同组分的比例比血清HBV DNA更好地预测[无活性的载体]阶段或总HBsAg水平，“研究人员总结说。 “我们建议LHBs和MHBs的比例可能比总HBsAg水平更有用于区分[慢性HBV]的无活性和活性形式。” - Talitha Bennett

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