乙型肝炎核心抗体基线水平预测ALT水平正常的HBeAg阳性儿童自

StephenW

Baseline Level of Hepatitis B Core Antibody Predicts Spontaneous HBeAg Seroconversion in HBeAg-Positive Children with a Normal ALT Level

    May 2019Hepatology

    Ho-Sheng Chen Jia-Feng Wu Jia-Feng Wu Tung-Hung Su Tung-Hung Su

    Mei-Hwei Chang


Abstract
It is not clear whether the baseline hepatitis B core antibody (anti-HBc) level in hepatitis B e
antigen (HBeAg)-positive children with a normal alanine aminotransferase (ALT) level is predictive of spontaneous HBeAg seroconversion. We investigated the correlation between the anti-HBc level and the natural course of chronic hepatitis B (CHB) virus (HBV) infection in children, particularly the ability of the baseline anti-HBc level to predict spontaneous HBeAg seroconversion during long-term follow-up. HBeAg-positive children with untreated CHB and a
normal ALT level were followed longitudinally. The anti-HBc level was determined by double-
sandwich immunoassay. The effects of anti-HBc levels and other parameters on spontaneous
HBeAg seroconversion and the natural course of CHB were assessed. A total of 182 children
(106 males) with a median age at enrollment of 10.6 (interquartile range 10.3–15.3) years was followed for a median of 19.8 (interquartile range 11.9–21.9) years. Spontaneous HBeAg seroconversion occurred in 85 children (46.7%) during the follow-up. A baseline anti-HBc titer
of > 500 IU/mL (hazard ratio= 2.81), HBV genotype B and B+C (hazard ratio= 3.46), and a
baseline hepatitis B surface antigen titer of ≤ 4.8 log10 IU/mL (hazard ratio= 3.09) were
predictive of spontaneous HBeAg seroconversion, based on multivariable survival analysis
(P < 0.001). In cases remaining HBeAg positive, their anti-HBc levels increased gradually during follow-up due to ongoing inflammation.
Conclusion: The baseline anti-HBc level is predictive of spontaneous HBeAg seroconversion in HBeAg-positive children with a normal ALT level. The anti-HBc level reflects anti-HBV
immune response in the HBeAg-positive normal ALT phase of CHB.

StephenW

乙型肝炎核心抗体基线水平预测ALT水平正常的HBeAg阳性儿童自发性HBeAg血清转换

    2019年5月肝病学

    陈浩峰何家峰吴东红苏东红苏

    Mei-Hwei Chang


抽象
尚不清楚乙肝的基线乙型肝炎核心抗体（抗-HBc）水平是否为e
具有正常丙氨酸氨基转移酶（ALT）水平的抗原（HBeAg）阳性儿童可预测自发性HBeAg血清转换。我们研究了儿童抗HBc水平与慢性乙型肝炎（CHB）病毒（HBV）感染的自然病程之间的相关性，特别是基线抗-HBc水平在长期随访期间预测自发性HBeAg血清转换的能力。起来。 HBeAg阳性的儿童未经治疗的CHB和a
纵向跟踪正常的ALT水平。抗HBc水平由双倍决定
夹心免疫分析。抗HBc水平和其他参数对自发性哮喘的影响
评估HBeAg血清学转换和CHB的自然过程。共有182名儿童
（106名男性）入选年龄中位数为10.6（四分位数间距为10.3-15.3）年，中位数为19.8（四分位数间距为11.9-21.9）年。随访期间，85名儿童（46.7％）发生自发性HBeAg血清学转换。基线抗HBc滴度
> 500 IU / mL（风险比= 2.81），HBV基因型B和B + C（风险比= 3.46），和
基线乙肝表面抗原滴度≤4.8log10 IU / mL（风险比= 3.09）
基于多变量生存分析预测自发性HBeAg血清学转换
（P <0.001）。在HBeAg阳性的情况下，由于持续的炎症，他们的抗HBc水平在随访期间逐渐增加。
结论：基线抗-HBc水平可预测ALe水平正常的HBeAg阳性儿童自发性HBeAg血清学转换。抗HBc水平反映了抗HBV
CHB的HBeAg阳性正常ALT期的免疫反应。