HBeAg阴性慢性感染患者自发性HBsAg血清清除率和血清转换的发

StephenW

J Viral Hepat. 2018 Aug 16. doi: 10.1111/jvh.12978. [Epub ahead of print]
Incidence and determinants of spontaneous HBsAg seroclearance and seroconversion in HBeAg negative chronic infection patients: a population based prospective cohort.
Zhu L1, Zhai X1, Wang Q2, Jiang J1, Peng H1, Song C3, Ge Z3, Qian J1, Zhou M1, Zhou Y2, Xu J4, Liu H5, Hang D3, Hu Z3, Shen H3, Zhu F1.
Author information

1
    Jiangsu Province Center for Disease Prevention and Control, Nanjing, China.
2
    Zhangjiagang Center for Disease Prevention and Control, Zhangjiagang, China.
3
    Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.
4
    Danyang Center for Disease Prevention and Control, Danyang, China.
5
    Taixing Center for Disease Prevention and Control, Taixing, China.

Abstract

Seroclearance of hepatitis B surface antigen (HBsAg) has been widely studied, however, seroconversion of HBsAg and characteristics of viral load among HBeAg negative chronic infection patients after HBsAg lost is not clear. We performed a large scale srtudy in a HBeAg negative chronic infection cohort to evaluate spontaneous HBsAg seroclearance incidence from Oct 2012 to April 2017 in Jiangsu province, China. We also elucidated the characteristics of HBsAg seroconversion and HBV DNA detectability among patients who cleared HBsAg. A total of 2,997 HBeAg negative chronic infection patients (mean age 52.3±12.9 years at baseline) were included. With 10,519 person years of follow up, 348 patients successfully spontaneously cleared HBsAg, with an incidence rate of 3.31 per 100 person-years. Patients with HBV DNA detectable ~1999 IU/ml at baseline had a lower probability of HBsAg seroclearance relative to those with undetectable HBV DNA, with a HR of 0.31 (95%CI=0.23, 0.41). HBsAg seroconversion occurred in 37.3% of those patients who cleared HBsAg. The geometric mean of anti-HBs among those with HBsAg conversion was 79.4 mIU/ml. Female had a higher HBsAg seroconversion rate (P=0.011). Among those with HBsAg seroclearance, 11.2% still had HBV-DNA levels of higher than 100IU/mL. Patients with higher HBV DNA at baseline had a higher risk of detectable HBV DNA levels even after HBsAg seroclearance (P<0.001). This study reveals HBsAg seroconversion rates and HBV DNA undetectability epidemiological characteristics of patients with HBsAg seroclearance, and suggests that monitoring HBV DNA is needed when managing HBeAg negative chronic patients, even after clearing HBsAg. This article is protected by copyright. All rights reserved.
KEYWORDS:

HBV DNA ; Cohort; HBeAg negative chronic infection; HBsAg seroclearance; HBsAg seroconversion

PMID:
    30112835
DOI:
    10.1111/jvh.12978

StephenW

J病毒肝病。 2018年8月16日doi：10.1111 / jvh.12978。 [提前打印]
HBeAg阴性慢性感染患者自发性HBsAg血清清除率和血清转换的发生率和决定因素：基于人群的前瞻性队列研究。
Zhu L1，Zhai X1，Wang Q2，Jiang J1，Peng H1，Song C3，Ge Z3，Qian J1，Zhou M1，Zhou Y2，Xu J4，Liu H5，Hang D3，Hu Z3，Shen H3，Zhu F1。
作者信息

1
    江苏省疾病预防控制中心，中国南京。
2
    中国张家港市张家港市疾病预防控制中心。
3
    南京医科大学公共卫生学院流行病学系，南京
4
    丹阳市丹阳市疾病预防控制中心。
五
    泰兴市泰兴市疾病预防控制中心

抽象

乙型肝炎表面抗原（HBsAg）的血清清除已被广泛研究，然而，HBsAg消失后HBeAg阴性慢性感染患者的HBsAg血清转换和病毒载量特征尚不清楚。我们对HBeAg阴性慢性感染队列进行了大规模的研究，以评估2012年10月至2017年4月在中​​国江苏省的自发性HBsAg血清清除率。我们还阐明了清除HBsAg的患者HBsAg血清转换和HBV DNA检测的特征。共纳入2,997例HBeAg阴性慢性感染患者（基线时平均年龄52.3±12.9岁）。随着10,519人年的随访，348名患者成功自发清除HBsAg，发病率为每100人年3.31。基线时可检测到~1999 IU / ml的HBV DNA患者相对于HBV DNA检测不到的HBsAg血清清除率较低，HR为0.31（95％CI = 0.23,0.41）。清除HBsAg的患者中有37.3％发生HBsAg血清学转换。 HBsAg转化者中抗-HBs的几何平均值为79.4 mIU / ml。女性HBsAg血清学转换率较高（P = 0.011）。在HBsAg血清清除率的患者中，11.2％的患者HBV-DNA水平仍高于100IU / mL。基线时HBV DNA较高的患者即使在HBsAg血清清除后也存在较高的可检测HBV DNA水平的风险（P <0.001）。本研究揭示HBsAg血清转换率和HBs DNA不可检测性HBsAg血清清除患者的流行病学特征，并表明即使在清除HBsAg后，在管理HBeAg阴性慢性患者时也需要监测HBV DNA。本文受版权保护。版权所有。
关键词：

HBV DNA;队列; HBeAg阴性慢性感染; HBsAg血清清除率; HBsAg血清学转换

结论：
    30112835
DOI：
    10.1111 / jvh.12978