血清乙肝核心抗体水平预测用核苷（酸）类似物治疗的高病

StephenW

Infect Drug Resist. 2018 Apr 3;11:469-477. doi: 10.2147/IDR.S163038. eCollection 2018.
Serum hepatitis B core antibody levels predict HBeAg seroconversion in chronic hepatitis B patients with high viral load treated with nucleos(t)ide analogs.
Cai S#1, Li Z#1, Yu T1, Xia M1, Peng J1.
Author information

1
    Department of Infectious Diseases and Hepatology Unit, NanFang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China.
#
    Contributed equally

Abstract
Background:

Patients with chronic hepatitis B virus (HBV) infection who are hepatitis B virus e antigen (HBeAg) positive are increasingly being treated with nucleos(t)ide analogs (NUCs). However, the predictive value of serum hepatitis B virus core antibody (HBcAb) levels for HBeAg seroconversion among patients with high viral load remains unclear.
Methods:

This study consisted of 74 patients with high viral load (HBV DNA >1 × 107 copies/mL) enrolled in a multicenter, randomized, controlled trial, treated with lamivudine and adefovir (N = 32) or entecavir (N = 42) for up to 96 weeks. Serum HBV DNA, quantitative hepatitis B virus surface antigen (HBsAg), HBeAg, and HBeAb was tested at each visit. Quantitative HBcAb evaluation was conducted for all the available samples in the trial, by using a newly developed double-sandwich anti-HBc immunoassay.
Results:

Serum HBcAb levels were significantly higher in patients with a serum alanine aminotransferase (ALT) level more than five times the upper limit of normal (ULN) compared with patients with ALT levels within 5 × ULN (4.25 ± 0.61 vs. 3.94 ± 0.47 log10 IU/mL, P = 0.0345). Patients with HBeAg seroconversion were associated with a higher level of HBcAb at baseline, compared with those without HBeAg seroconversion (4.38 ± 0.54 vs. 4.02 ± 0.58 log10 IU/mL, P = 0.029). The area under receiver operating characteristic curve of baseline HBcAb for HBeAg seroconversion was 0.71 (95% CI: 0.55-0.86, P = 0.013). When the baseline HBcAb level was >4.375 log10 IU/mL, the sensitivity and specificity to predict HBeAg seroconversion at week 96 were 62.5% and 74.2%, and the positive likelihood ratio (LR) and negative LR were 2.42 and 0.51, respectively. The multivariate analysis result indicated that baseline serum HBcAb level was the only independent predictor for HBeAg seroconversion at week 96, with an odds ratio of 4.78.
Conclusion:

Baseline serum HBcAb level >4.375 log10 IU/mL could satisfactorily predict HBeAg seroconversion among patients with high viral load treated with NUC.
KEYWORDS:

HBV: hepatitis B core antibody; chronic hepatitis B; hepatitis B e antigen; high viral load; seroconversion

PMID:
    29662321
PMCID:
    PMC5892618
DOI:
    10.2147/IDR.S163038

StephenW

感染药物抵抗。 2018年4月3日; 11：469-477。 doi：10.2147 / IDR.S163038。 eCollection 2018年。
血清乙肝核心抗体水平预测用核苷（酸）类似物治疗的高病毒载量的慢性乙型肝炎患者中的HBeAg血清转化。
Cai S＃1，Li Z＃1，Yu T1，Xia M1，Peng J1。
作者信息

1
    南方医科大学南方医院感染与肝病科，广东省广州市。
＃
    平等贡献

抽象
背景：

患有乙型肝炎病毒e抗原（HBeAg）阳性的慢性乙型肝炎病毒（HBV）感染的患者正越来越多地使用核苷（酸）类似物（NUC）治疗。然而，血清乙型肝炎病毒核心抗体（HBcAb）水平对高病毒载量患者HBeAg血清转换的预测价值仍不清楚。
方法：

本研究包括74名接受拉米夫定和阿德福韦（N = 32）或恩替卡韦（N = 42）治疗的多中心，随机对照试验的高病毒载量（HBV DNA> 1×107拷贝/ mL）到96周。在每次就诊时测试血清HBV DNA，定量乙型肝炎病毒表面抗原（HBsAg），HBeAg和HBeAb。通过使用新开发的双夹心抗-HBc免疫测定法对所有可用样品进行定量HBcAb评估。
结果：

血清丙氨酸转氨酶（ALT）水平超过正常上限（ULN）上限5倍的患者血清HBcAb水平显着高于ALT水平在5×ULN范围内的患者（4.25±0.61比3.94±0.47 log10 IU / mL，P = 0.0345）。 HBeAg血清转换患者基线时HBcAb水平高于无HBeAg血清学转换者（4.38±0.54 vs. 4.02±0.58 log10 IU / mL，P = 0.029）。基线HBcAb HBeAg血清学转换的受试者工作特征曲线下面积为0.71（95％CI：0.55-0.86，P = 0.013）。当基线HBcAb水平> 4.375 log10 IU / mL时，96周时预测HBeAg血清转换的敏感性和特异性分别为62.5％和74.2％，阳性似然比（LR）和阴性LR分别为2.42和0.51。多变量分析结果表明，基线血清HBcAb水平是96周时HBeAg血清学转换的唯一独立预测因子，优势比为4.78。
结论：

基线血清HBcAb水平> 4.375 log10 IU / mL可以令人满意地预测NUC治疗的高病毒载量患者的HBeAg血清学转换。
关键词：

HBV：乙型肝炎核心抗体;慢性乙型肝炎;乙型肝炎e抗原;高病毒载量;血清转换

结论：
    29662321
PMCID：
    PMC5892618
DOI：
    10.2147 / IDR.S163038

StephenW

https://www.dovepress.com/serum- ... ulltext-article-IDR