乙型肝炎核心相关抗原与乙型肝炎表面抗原和乙型肝炎病毒DN

StephenW

Ann Lab Med. 2019 Jan;39(1):67-75. doi: 10.3343/alm.2019.39.1.67.
Performance of Hepatitis B Core-Related Antigen Versus Hepatitis B Surface Antigen and Hepatitis B Virus DNA in Predicting HBeAg-positive and HBeAg-negative Chronic Hepatitis.
Zhang ZQ#1, Wang YB#2, Lu W2, Liu DP2, Shi BS3, Zhang XN3, Huang D2, Li XF2, Zhou XL2, Ding RR2.
Author information

1
    Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center of Fudan University, Shanghai, China. [email protected].
2
    Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center of Fudan University, Shanghai, China.
3
    Research Unit, Shanghai Public Health Clinical Center of Fudan University, Shanghai, China.
#
    Contributed equally

Abstract
BACKGROUND:

We examined changes in hepatitis B core-related antigen (HBcrAg) during the four sequential phases of chronic hepatitis B virus (HBV) infection: hepatitis B e antigen (HBeAg)-positive chronic infection (EPCI) and hepatitis (EPCH), followed by HBeAg-negative chronic infection (ENCI) and hepatitis (ENCH). We compared the performance of serum HBcrAg, hepatitis B surface antigen (HBsAg), and HBV DNA in predicting EPCH and ENCH.
METHODS:

We enrolled 492 consecutive patients: 49 with EPCI, 243 with EPCH, 101 with ENCI, and 99 with ENCH. HBcrAg was detected by chemiluminescent enzyme immunoassays. HBsAg and HBeAg were detected by chemiluminescent microparticle immunoassays. HBV DNA was detected by real-time PCR. Predictive performance of HBcrAg, HBsAg, and HBV DNA was evaluated using ROC curves.
RESULTS:

Areas under ROC curves (AUCs) of HBcrAg, HBsAg, and HBV DNA for predicting EPCH were 0.738, 0.812, and 0.717, respectively; optimal cutoffs were ≤1.43×10⁵ kU/mL, ≤1.89×10⁴ IU/mL, and ≤3.97×10⁷ IU/mL, with sensitivities and specificities of 66.3% and 77.6%, 65.0% and 93.9%, and 60.5% and 79.6%, respectively. AUCs of HBcrAg, HBsAg, and HBV DNA for predicting ENCH were 0.887, 0.581, and 0.978, respectively; optimal cutoffs were >26.8 kU/mL, >2.29×10² IU/mL, and >8.75×10³ IU/mL, with sensitivities and specificities of 72.7% and 95.1%, 86.9% and 39.6%, and 89.9% and 92.1%, respectively.
CONCLUSIONS:

HBsAg and HBV DNA were the best predictors of EPCH and ENCH, respectively. HBcrAg is an important surrogate marker for predicting EPCH and ENCH.

© The Korean Society for Laboratory Medicine.
KEYWORDS:

Chronic hepatitis B; Hepatitis B core-related antigen; Hepatitis B surface antigen; Hepatitis B virus DNA; Performance

PMID:
    30215232
DOI:
    10.3343/alm.2019.39.1.67

StephenW

Ann Lab Med。 2019年1月; 39（1）：67-75。 doi：10.3343 / alm.2019.39.1.67。
乙型肝炎核心相关抗原与乙型肝炎表面抗原和乙型肝炎病毒DNA预测HBeAg阳性和HBeAg阴性慢性肝炎的表现。
Zhang ZQ＃1，Wang YB＃2，Lu W2，Liu DP2，Shi BS3，Zhang XN3，Huang D2，Li XF2，Zhou XL2，Ding RR2。
作者信息

1
    复旦大学上海市公共卫生临床中心肝胆外科，上海[email protected]。
2
    复旦大学上海市公共卫生临床中心肝胆外科，上海
3
    复旦大学上海市公共卫生临床中心研究室，上海。
＃
    贡献一致

抽象
背景：

我们检测了慢性乙型肝炎病毒（HBV）感染的四个连续阶段乙型肝炎核心相关抗原（HBcrAg）的变化：乙型肝炎e抗原（HBeAg）阳性慢性感染（EPCI）和肝炎（EPCH），其次是HBeAg阴性慢性感染（ENCI）和肝炎（ENCH）。我们比较了血清HBcrAg，乙型肝炎表面抗原（HBsAg）和HBV DNA在预测EPCH和ENCH方面的表现。
方法：

我们招募了492名连续患者：其中49名患有EPCI，243名患有EPCH，101名患有ENCI，99名患有ENCH。通过化学发光酶免疫测定法检测HBcrAg。通过化学发光微粒免疫测定法检测HBsAg和HBeAg。通过实时PCR检测HBV DNA。使用ROC曲线评估HBcrAg，HBsAg和HBV DNA的预测性能。
结果：

用于预测EPCH的HBcrAg，HBsAg和HBV DNA的ROC曲线下面积（AUC）分别为0.738,0.812和0.717;最佳截止值≤1.43×10⁵kU/ mL，≤1.89×10⁴IU/ mL，≤3.97×10⁷IU/ mL，灵敏度和特异性分别为66.3％和77.6％，65.0％和93.9％，以及60.5％和79.6 ％， 分别。用于预测ENCH的HBcrAg，HBsAg和HBV DNA的AUC分别为0.887,0.581和0.978;最佳截止值> 26.8 kU / mL，> 2.29×10 2 IU / mL，> 8.75×10 3 IU / mL，灵敏度和特异度分别为72.7％和95.1％，86.9％和39.6％，89.9％和92.1％，分别。
结论：

HBsAg和HBV DNA分别是EPCH和ENCH的最佳预测因子。 HBcrAg是预测EPCH和ENCH的重要替代指标。

©韩国检验医学会。
关键词：

慢性乙型肝炎;乙型肝炎核心相关抗原;乙型肝炎表面抗原;乙型肝炎病毒DNA;性能

结论：
    30215232
DOI：
    10.3343 / alm.2019.39.1.67