早期血清HBsAg下降是先前核（t）ide类似物暴露的慢性乙型肝

StephenW

Med Sci Monit. 2019 Jun 23;25:4665-4674. doi: 10.12659/MSM.916441.
Early Serum HBsAg Drop Is a Strong Predictor of HBeAg Seroconversion and HBsAg Loss to Pegylated Interferon Alfa-2a in Chronic Hepatitis B Patients with Prior Nucleos(t)ide Analogue Exposure.
Chen Q1, Zhang J2, Huang J3, Quan B4, Wu X5, Deng S6, Han W3.
Author information

1
    Department of Nuclear Medicine, The First Affiliated Hospital of Wanan Medical College, Wuhu, Anhui, China (mainland).
2
    Clinical Blood Laboratory, The First Affiliated Hospital of Wanan Medical College, Wuhu, Anhui, China (mainland).
3
    Clinical Laboratory, The First Affiliated Hospital of Wanan Medical College, Wuhu, Anhui, China (mainland).
4
    Department of Infectious Diseases, The First Affiliated Hospital of Wanan Medical College, Wuhu, Anhui, China (mainland).
5
    State Key Laboratory for Infectious Diseases Diagnosis and Treatment, Department of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China (mainland).
6
    Department of Nuclear Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland).

Abstract

BACKGROUND High rates of HBeAg and/or HBsAg seroconversion or clearance have been achieved in chronic hepatitis B (CHB) patients receiving pegylated interferon (pegIFN) in addition to ongoing nucleos(t)ide analogue (NUC) treatment. In the present study, we aimed to evaluate HBsAg kinetics to predict HBeAg seroconversion and HBsAg clearance in these patients. MATERIAL AND METHODS A total of 33 HBeAg-positive and 17 HBeAg-negative patients were enrolled between January 2010 and January 2018. At the end of pegIFN treatment, 9 of 50 patients achieved HBsAg clearance, and 9 of 33 HBeAg-positive patients achieved HBeAg seroconversion. RESULTS The cutoff value of 0.41 log₁₀ IU/mL in HBsAg decline at week 12 had a positive predictive value (PPV) of 58.3% and a negative predictive value (NPV) of 94.6% for HBsAg clearance. The cutoff value of 1.94 log₁₀ IU/mL in HBsAg decline at week 24 had a PPV of 80.0% and an NPV of 97.5% for HBsAg clearance. The cutoff value of 0.47 log₁₀ IU/mL in HBsAg decline at week 12 had a PPV of 83.3% and an NPV of 85.2% for HBeAg seroconversion. The cutoff value of 1.29 log₁₀ IU/mL in in HBsAg decline at week 24 had a PPV of 85.7% and an NPV of 88.5% for HBeAg seroconversion. CONCLUSIONS Early HBsAg drop has a high predictive value for HBsAg clearance and HBeAg seroconversion in patients who were treated with combination therapy of pegIFN and NUCs.

PMID:
    31230063
DOI:
    10.12659/MSM.916441

StephenW

Med Sci Monit。 2019年6月23日; 25：4665-4674。 doi：10.12659 / MSM.916441。
早期血清HBsAg下降是先前核（t）ide类似物暴露的慢性乙型肝炎患者中HBeAg血清转换和HBsAg丢失至聚乙二醇化干扰素α-2a的强预测因子。
Chen Q1，Zhang J2，Huang J3，Quan B4，Wu X5，Deng S6，Han W3。
作者信息

1
    安徽省芜湖市万安医学院第一附属医院核医学科（大陆）
2
    中国安徽省芜湖市万安医学院第一附属医院临床血液实验室。
3
    中国安徽省芜湖市万安医学院第一附属医院临床实验室。
4
    中国安徽省芜湖市万安医学院第一附属医院感染科
五
    浙江大学医学院附属第一医院传染病传染病诊疗国家重点实验室，浙江杭州（大陆）。
6
    苏州大学附属第一医院核医学科，中国江苏苏州（大陆）。

抽象

背景技术除了正在进行的核苷（t）ide类似物（NUC）治疗之外，在接受聚乙二醇化干扰素（pegIFN）的慢性乙型肝炎（CHB）患者中已经实现了高比率的HBeAg和/或HBsAg血清转换或清除。在本研究中，我们旨在评估HBsAg动力学，以预测这些患者的HBeAg血清转换和HBsAg清除率。材料与方法2010年1月至2018年1月共收治33例HBeAg阳性和17例HBeAg阴性患者。在pegIFN治疗结束时，50例患者中有9例达到HBsAg清除率，33例HBeAg阳性患者中有9例达到HBeAg血清学转换。结果HBsAg在第12周时的截止值为0.41 log 10 IU / mL，阳性预测值（PPV）为58.3％，HBsAg清除率为阴性预测值（NPV）为94.6％。 HBsAg在第24周时的截止值为1.94log 10 IU / mL，PPV为80.0％，HBsAg清除率为NPV为97.5％。 HBsAg在第12周时的截止值为0.47log 10 IU / mL，对于HBeAg血清转换，PPV为83.3％，NPV为85.2％。 HBsAg在24周时的截止值为1.29log 10 IU / mL，PPV为85.7％，HBeAg血清转换的NPV为88.5％。结论早期HBsAg下降对pegIFN和NUC联合治疗患者的HBsAg清除率和HBeAg血清转换具有较高的预测价值。

结论：
    31230063
DOI：
    10.12659 / MSM.916441

小牡丹

早期下降多，究竟是免疫的结果还是药物的结果？似乎免疫差，则药物无所作为。免疫系统发力后，很多人不用治疗可自愈。