慢性乙型肝炎患者中白蛋白-胆红素评分与对聚乙二醇化干扰

StephenW

Clin Chim Acta. 2019 Dec 28. pii: S0009-8981(19)32189-8. doi: 10.1016/j.cca.2019.12.020. [Epub ahead of print]
Albumin-bilirubin score is associated with response to pegylated interferon and nucleos(t)ide analogues in chronic hepatitis B patients.
Xun Z1, Liu C2, Yu QQ1, Lin JP2, Huang JL2, Yang TW3, Wu WN4, Wu SH4, Ou QS5.
Author information

1
    First Clinical College, Fujian Medical University, Fuzhou, China; Department of Laboratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China; Fujian Key Laboratory of Laboratory Medicine.
2
    Department of Laboratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China; Gene Diagnostic Laboratory, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China; Fujian Key Laboratory of Laboratory Medicine.
3
    First Clinical College, Fujian Medical University, Fuzhou, China.
4
    Department of Laboratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China; Gene Diagnostic Laboratory, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
5
    Department of Laboratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China; Gene Diagnostic Laboratory, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China; Fujian Key Laboratory of Laboratory Medicine. Electronic address: [email protected].

Abstract
BACKGROUND AND AIM:

Recently, the role of albumin-bilirubin (ALBI) score in chronic hepatitis B (CHB) has not been well-understood. We aimed to investigate the association of ALBI score with natural history of chronic HBV infection and treatment response of CHB patients.
METHODS:

The ALBI score in a cohort of 849 individuals including 721 chronic HBV-infected patients naïve to anti-HBV treatment in different phases and 128 healthy controls were estimated. Additionally, the dynamic changes of ALBI score of 243 hepatitis B e antigen (HBeAg)-positive CHB patients treated with pegylated interferon-alpha (PEG-IFN-α) or nucleos(t)ide analogues (NAs) were tested for 72 weeks.
RESULTS:

ALBI score differed among phases, with the highest score in HBeAg-positive CHB patients, followed by HBeAg-negative CHB patients, HBeAg-positive chronic HBV infection, and HBeAg-negative chronic HBV infection. Besides, CHB patients harbouring high baseline ALBI score exhibited a relatively stronger therapeutic response to PEG-IFN-α or NAs. Moreover, the rate of HBeAg and HBsAg loss in patients with ALBI grade 2 was persistently higher than that in patients with ALBI grade 1 throughout the course of treatment. Furthermore, ALBI score was an independent predictor of sustained response achievement. The combined use of ALBI score, HBeAg and ALT could enhance the predictive value of treatment response.
CONCLUSIONS:

ALBI score differed significantly across the natural course of chronic HBV infection and was correlated with PEG-IFN-α and NAs treatment response in HBeAg-positive CHB patients, which suggested that ALBI score could be useful as an auxiliary clinical factor to determine the initiation of therapy and predict stronger antiviral treatment response.

Copyright © 2019. Published by Elsevier B.V.
KEYWORDS:

Albumin-bilirubin; Chronic hepatitis B; Natural history; Nucleos(t)ide analogues; Pegylated interferon; Treatment response

PMID:
    31891671
DOI:
    10.1016/j.cca.2019.12.020

StephenW

Clin Chim Acta。 2019年12月28日.pii：S0009-8981（19）32189-8。 doi：10.1016 / j.cca.2019.12.020。 [Epub提前发布]
慢性乙型肝炎患者中白蛋白-胆红素评分与对聚乙二醇化干扰素和核苷（核苷酸）类似物的反应有关。
Xun Z1，Liu C2，Yu QQ1，Lin JP2，Huang JL2，Yang TW3，Wu WN4，Wu SH4，Ou QS5。
作者信息

1个
    福建医科大学第一临床学院，福州；福建医科大学附属第一医院检验医学科，福州；福建省检验医学重点实验室。
2
    福建医科大学附属第一医院检验医学科，福州；福建医科大学附属第一医院基因诊断实验室，福州；福建省检验医学重点实验室。
3
    福建医科大学第一临床学院，福州。
4
    福建医科大学附属第一医院检验医学科，福州；福建医科大学附属第一医院基因诊断实验室，福州。
5
    福建医科大学附属第一医院检验医学科，福州；福建医科大学附属第一医院基因诊断实验室，福州；福建省检验医学重点实验室。电子地址：[email protected]。

抽象
背景与目的：

最近，白蛋白-胆红素（ALBI）评分在慢性乙型肝炎（CHB）中的作用尚未得到很好的理解。我们旨在调查ALBI评分与慢性HBV感染的自然病史和CHB患者的治疗反应之间的关系。
方法：

估计849名患者的ALBI评分，包括721名在不同阶段未接受抗HBV治疗的慢性HBV感染患者和128名健康对照者。此外，测试了使用聚乙二醇化干扰素-α（PEG-IFN-α）或核苷酸（t）ide类似物（NAs）治疗的243名乙型肝炎e抗原（HBeAg）阳性CHB患者ALBI评分的动态变化，持续了72周。
结果：

ALBI评分在各个阶段之间有所不同，在HBeAg阳性CHB患者中得分最高，其次是HBeAg阴性CHB患者，HBeAg阳性慢性HBV感染和HBeAg阴性慢性HBV感染。此外，基线ALBI得分较高的CHB患者对PEG-IFN-α或NAs的治疗反应相对较强。此外，在整个治疗过程中，ALBI 2级患者的HBeAg和HBsAg丢失率持续高于ALBI 1级患者。此外，ALBI评分是持续反应成绩的独立预测指标。 ALBI评分，HBeAg和ALT的联合使用可以提高治疗反应的预测价值。
结论：

在慢性HBV感染的自然过程中，ALBI评分存在显着差异，并且与HBeAg阳性CHB患者的PEG-IFN-α和NAs治疗反应相关，这表明ALBI评分可作为辅助临床因素来确定HBeAg阳性的开始疗法并预测更强的抗病毒治疗反应。

版权所有©2019.Elsevier B.V.
关键字：

白蛋白胆红素慢性乙型肝炎；自然历史;核苷类似物；聚乙二醇干扰素；治疗反应

PMID：
    31891671
DOI：
    10.1016 / j.cca.2019.12.020

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