血清HBV RNA的基线和动力学预测HBeAg阴性慢性乙型肝炎患者对

StephenW

J Viral Hepat. 2019 Aug 25. doi: 10.1111/jvh.13195. [Epub ahead of print]
Baseline and kinetics of serum HBV RNA predict response to pegylated interferon-based therapy in patients with HBeAg-negative chronic hepatitis B.
Limothai U1, Chuaypen N1, Poovorawan K2, Chotiyaputta W3, Tanwandee T3, Poovorawan Y4, Tangkijvanich P1.
Author information

1
    Center of Excellence in Hepatitis and Liver Cancer, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
2
    Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
3
    Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
4
    Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Abstract

Serum hepatitis B virus (HBV) RNA has emerged as a novel biomarker of treatment response. This study aimed to investigate the role of this marker in predicting long-term outcome of patients with HBeAg-negative chronic hepatitis B (CHB) receiving pegylated interferon (PEG-IFN)-based therapy. Serial serum samples from 91 patients with HBeAg-negative CHB previously treated with PEG-IFN alone or combined with entecavir in a randomized trial were retrospectively analyzed. HBV RNA quantification was examined by droplet digital PCR. At the end of 3 years post-treatment follow-up, maintained virological response (MVR, HBV DNA <2,000 IU/mL), and HBsAg clearance were achieved in 37.4% (34/91) and 7.7% (7/91), respectively. Baseline serum HBV RNA concentrations correlated with HBV DNA and cccDNA but did not correlate with HBsAg levels. Multiple regression analysis showed that pretreatment HBV RNA and HBsAg were independently associated with MVR and HBsAg clearance. Baseline HBV RNA (cut-off 2.0 log10 copies/mL) had a positive predictive value (PPV) and a negative predictive value (NPV) in predicting MVR of 80.8% and 80.0%, respectively. At the same cut-off value, PPV and NPV for predicting HBsAg clearance were 30.8% and 95.4%, respectively. At week 12 during therapy, HBV RNA level ≥ 2 log10 copies/mL displayed high NPVs of achieving MVR and HBsAg clearance (95% and 100%, respectively). In conclusion, the measurement of HBV RNA prior to PEG-IFN-based therapy could identify patients with high probability of MVR. In addition, HBV RNA kinetics may serve as a promising 'stopping rule' in patients infected with HBV genotypes B or C. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.
KEYWORDS:

HBV RNA ; Chronic hepatitis B; HBsAg; cccDNA; entecavir; pegylated interferon; stopping rule; virological response

PMID:
    31446638
DOI:
    10.1111/jvh.13195

StephenW

J病毒肝病。 2019年8月25日.doi：10.1111 / jvh.13195。 [印刷前的电子版]
血清HBV RNA的基线和动力学预测HBeAg阴性慢性乙型肝炎患者对聚乙二醇干扰素治疗的反应。
Limothai U1，Chuaypen N1，Poovorawan K2，Chotiyaputta W3，Tanwandee T3，Poovorawan Y4，Tangkijvanich P1。
作者信息

1
    泰国曼谷朱拉隆功大学医学院肝炎和肝癌卓越中心。
2
    泰国曼谷玛希隆大学热带医学系临床热带医学系。
3
    泰国曼谷玛希隆大学Siriraj医学院医学系。
4
    泰国曼谷朱拉隆功大学医学院临床病毒学卓越中心。

抽象

血清乙型肝炎病毒（HBV）RNA已成为治疗反应的新型生物标志物。本研究旨在探讨该标志物在预测接受聚乙二醇干扰素（PEG-IFN）治疗的HBeAg阴性慢性乙型肝炎（CHB）患者的长期预后中的作用。回顾性分析了91例HBeAg阴性CHB患者的血清样本，这些患者之前单独用PEG-IFN或与恩替卡韦联合治疗。通过液滴数字PCR检查HBV RNA定量。在治疗后随访3年结束时，维持病毒学应答（MVR，HBV DNA <2,000 IU / mL）和HBsAg清除率分别达到37.4％（34/91）和7.7％（7/91），分别。基线血清HBV RNA浓度与HBV DNA和cccDNA相关，但与HBsAg水平无关。多元回归分析显示，预处理HBV RNA和HBsAg与MVR和HBsAg清除率独立相关。基线HBV RNA（截止值2.0 log10拷贝/ mL）在预测MVR分别为80.8％和80.0％时具有阳性预测值（PPV）和阴性预测值（NPV）。在相同的临界值下，预测HBsAg清除率的PPV和NPV分别为30.8％和95.4％。在治疗期间的第12周，HBV RNA水平≥2log10拷贝/ mL显示出达到MVR和HBsAg清除的高NPV（分别为95％和100％）。总之，在基于PEG-IFN的治疗之前测量HBV RNA可以鉴定具有高MVR概率的患者。此外，HBV RNA动力学可能成为感染HBV基因型B或C的患者的一个有希望的“停止规则”。本文受版权保护。版权所有。

本文受版权保护。版权所有。
关键词：

HBV RNA;慢性乙型肝炎;乙肝表面抗原; cccDNA的;恩替卡韦;聚乙二醇化干扰素;停止规则;病毒学反应

结论：
    31446638
DOI：
    10.1111 / jvh.13195

纠结哥哥

白血病已经被日本攻克，乙肝还会远吗？是不是相似的机制