未接受过治疗的CHB患者血清乙型肝炎表面抗原与乙型肝炎核

StephenW

J Chin Med Assoc. 2018 Aug 22. pii: S1726-4901(18)30198-9. doi: 10.1016/j.jcma.2018.05.007. [Epub ahead of print]
Correlations between serum hepatitis B surface antigen and hepatitis B core antibody titers and liver fibrosis in treatment-naïve CHB patients.
Li MR1, Zheng HW1, Ma SM2, Liu YY1, Qie LX1, Li JQ1, Wang DH1, Sun XL1, Ren GF1, Zheng YH1, Wang YL1, Dai EH3.
Author information

1
    Division of Liver Disease, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, Hebei, China.
2
    Department of General Surgery, North China Petroleum Bureau General Hospital, Renqiu, Hebei, China.
3
    Division of Liver Disease, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, Hebei, China. Electronic address: [email protected].

Abstract
BACKGROUND:

Previous studies have revealed that quantitative hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (qAnti-HBc) levels can be used as predictors of treatment response in both interferon-α and nucleoside analogue therapies. Few data have been published regarding the relationship between quantitative HBsAg or Anti-HBc levels and liver fibrosis stages in patients with chronic hepatitis B (CHB).
METHODS:

We conducted a cross-sectional study of treatment-naïve CHB patients. A total of 624 CHB patients were recruited. We assessed the serum HBsAg and qAnti-HBc levels, HBV DNA levels, HBV genotypes, BCP/PC mutations, histological fibrosis staging by Scheuer classification.
RESULTS:

In HBeAg (+) patients, the S0-1 subjects had significantly higher serum HBsAg and lower qAnti-HBc levels than the S2-4 subjects (both p < 0.001). A moderate inverse correlation was present between serum HBsAg levels and fibrosis scores (r = -0.381, p < 0.001), and a moderate positive correlation was found between qAnti-HBc levels and fibrosis scores (r = 0.408, p < 0.001). In the HBeAg (-) patients, the S0-1 subjects also had significantly lower qAnti-HBc levels than the S2-4 subjects (p < 0.001); however, no significant difference in the HBsAg levels was observed between the S0-1 and S2-4 subjects (p > 0.05). Serum qAnti-HBc levels showed a moderate positive correlation with fibrosis scores (r = 0.383, p < 0.001), while serum HBsAg levels exhibited a low inverse correlation with fibrosis scores (r = -0.171, p < 0.001). Multiple logistic regression analysis showed that the parameters for predicting significant fibrosis (S ≥ 2) included age, PLT, qAnti-HBc levels, HBV genotype and BCP/PC mutations in HBeAg (+) group, and age, PLT, qAnti-HBc levels in HBeAg (-) group (all p < 0.05). The AUC of qAnti-HBc levels associated with the diagnosis of significant fibrosis abnormalities in HBeAg (+) and HBeAg (-) patients were 0.734 (95%CI 0.689 to 0.778) and 0.707 (95%CI 0.612 to 0.801), respectively.
CONCLUSION:

Our study found an association between high serum qAnti-HBc levels and significant fibrosis in both HBeAg (+) and HBeAg (-) treatment-naïve CHB patients. However, low serum HBsAg levels were correlated with moderate to severe fibrosis in HBeAg (+) subjects only.

Copyright © 2018. Published by Elsevier Taiwan LLC.
KEYWORDS:

Chronic hepatitis B; Hepatitis B surface antigen; Liver fibrosis; Quantitative anti-HBc

PMID:
    30143430
DOI:
    10.1016/j.jcma.2018.05.007

StephenW

J Chin Med Assoc。 2018年8月22日.pii：S1726-4901（18）30198-9。 doi：10.1016 / j.jcma.2018.05.007。 [提前打印]
未接受过治疗的CHB患者血清乙型肝炎表面抗原与乙型肝炎核心抗体滴度和肝纤维化的相关性。
Li MR1，Zheng HW1，Ma SM2，Liu YY1，Qie LX1，Li JQ1，Wang DH1，Sun XL1，Ren GF1，Zheng YH1，Wang YL1，Dai EH3。
作者信息

1
    河北医科大学附属石家庄市第五医院肝病科，河北石家庄
2
    华北石油局总医院普外科，河北任丘
3
    河北医科大学附属石家庄市第五医院肝病科，河北石家庄电子地址：[email protected]。

抽象
背景：

以前的研究表明，定量乙型肝炎表面抗原（HBsAg）或乙型肝炎核心抗体（qAnti-HBc）水平可用作干扰素-α和核苷类似物治疗中治疗反应的预测因子。关于慢性乙型肝炎（CHB）患者中定量HBsAg或抗-HBc水平与肝纤维化分期之间关系的数据尚未公布。
方法：

我们对未接受治疗的CHB患者进行了横断面研究。共招募了624名CHB患者。我们通过Scheuer分类评估了血清HBsAg和qAnti-HBc水平，HBV DNA水平，HBV基因型，BCP / PC突变，组织学纤维化分期。
结果：

在HBeAg（+）患者中，S0-1受试者具有显着高于S2-4受试者的血清HBsAg和较低的qAnti-HBc水平（均p <0.001）。血清HBsAg水平与纤维化评分呈现中度负相关（r = -0.381，p <0.001），qAnti-HBc水平与纤维化评分之间呈中度正相关（r = 0.408，p <0.001）。在HBeAg（ - ）患者中，S0-1受试者的qAnti-HBc水平也显着低于S2-4受试者（p <0.001）;然而，在S0-1和S2-4受试者之间未观察到HBsAg水平的显着差异（p> 0.05）。血清qAnti-HBc水平与纤维化评分呈中度正相关（r = 0.383，p <0.001），而血清HBsAg水平与纤维化评分呈低反相关（r = -0.171，p <0.001）。多因素Logistic回归分析显示，预测显着纤维化（S≥2）的参数包括HBeAg（+）组的年龄，PLT，qAnti-HBc水平，HBV基因型和BCP / PC突变，以及年龄，PLT，qAnti-HBc水平在HBeAg（ - ）组中（均p <0.05）。与HBeAg（+）和HBeAg（ - ）患者中显着纤维化异常的诊断相关的qAnti-HBc水平的AUC分别为0.734（95％CI 0.689至0.778）和0.707（95％CI 0.612至0.801）。
结论：

我们的研究发现，HBeAg（+）和HBeAg（ - ）治疗初治的CHB患者血清qAnti-HBc水平与显着纤维化之间存在相关性。然而，低血清HBsAg水平仅与HBeAg（+）受试者的中度至重度纤维化相关。

版权所有©2018。由Elsevier Taiwan LLC出版。
关键词：

慢性乙型肝炎;乙型肝炎表面抗原;肝纤维化;定量抗HBc

结论：
    30143430
DOI：
    10.1016 / j.jcma.2018.05.007

StephenW

https://www.sciencedirect.com/sc ... 18301989?via%3Dihub