慢性乙型肝炎病毒在肝炎中的自發耀斑是抗原陰性載體，其

StephenW

Dig Dis Sci. 2020 Feb 7. doi: 10.1007/s10620-020-06125-5. [Epub ahead of print]
Spontaneous Flares of Chronic Hepatitis B Virus in Hepatitis Be Antigen Negative Carriers Who Subsequently Clear Hepatitis B Surface Antigen.
Iluz-Freundlich D1, Samad N1, Miles D1, Osiowy C2, Kaita K1, Wong S1, Cuvelier S1, Peretz D1, Uhanova J1, Minuk GY3,4.
Author information

1
    Section of Hepatology, Department of Medicine, John Buhler Research Centre, University of Manitoba, 715 McDermot Ave., Winnipeg, MB, R3E 3P4, Canada.
2
    National Microbiology Laboratory, Winnipeg, MB, Canada.
3
    Section of Hepatology, Department of Medicine, John Buhler Research Centre, University of Manitoba, 715 McDermot Ave., Winnipeg, MB, R3E 3P4, Canada. [email protected].
4
    Pharmacology and Therapeutics, University of Manitoba, Winnipeg, Canada. [email protected].

Abstract
BACKGROUND:

Acute exacerbations of chronic hepatitis B virus (HBV) infections can occur in HBV-infected, hepatitis e antigen (HBeAg)-negative patients in the absence of recent withdrawal of antiviral or immunosuppressive therapies. Whether these spontaneous "flares" predict subsequent loss of hepatitis B surface antigen (HBsAg) has yet to be determined.
OBJECTIVES:

To document the percent of patients who experience spontaneous HBV flares and severity of the flares in chronic HBeAg-negative carriers.
METHODS:

A retrospective review of an HBV database identified and followed HBeAg-negative patients for biochemical evidence of flares (ALT > 5× normal) and subsequent HBsAg status. Patients that subsequently cleared HBsAg were matched 1:1 with those who remained HBsAg positive.
RESULTS:

Of 1299 HBeAg-negative patients followed for 10.2 ± 6.1 years, 88 (6.8%) developed spontaneous HBV flares. Flares occurred in 14/115 (12.2%) patients who subsequently cleared HBsAg and 4/111 (3.6%) matched patients who remained HBsAg positive (p = 0.025). The severity of flares was similar in the two study cohorts. Following multivariate analyses, only low HBV-DNA levels at baseline identified patients likely to subsequently clear HBsAg.
CONCLUSIONS:

Although more common in patients who subsequently clear HBsAg, spontaneous HBV flares do not predict subsequent HBsAg clearance.
KEYWORDS:

Flares; HBV-DNA; HBeAg; HBsAg; Hepatitis B; Reactivation

PMID:
    32034604
DOI:
    10.1007/s10620-020-06125-5

StephenW

Dig Dis Sci。 2020年2月7日。doi：10.1007 / s10620-020-06125-5。 [Epub提前發行]
慢性乙型肝炎病毒在肝炎中的自發耀斑是抗原陰性載體，其隨後清除了乙型肝炎表面抗原。
Iluz-Freundlich D1，Samad N1，Miles D1，Osiowy C2，Kaita K1，Wong S1，Cuvelier S1，Peretz D1，Uhanova J1，Minuk GY3,4。
作者信息

1個
    曼尼托巴大學約翰·布勒研究中心醫學系肝病科，加拿大溫尼伯，麥克德莫特大街715號，加拿大，R3E 3P4。
2
    加拿大MB溫尼伯國家微生物學實驗室。
3
    曼尼托巴大學約翰·布勒研究中心醫學系肝病科，加拿大溫尼伯，麥克德莫特大街715號，加拿大，R3E 3P4。 [email protected]。
4
    加拿大曼尼托巴大學藥理學和治療學。 [email protected]。

抽象
背景：

在沒有最近撤消抗病毒或免疫抑制療法的情況下，慢性乙型肝炎病毒（HBV）感染的急性加重可能發生在被乙肝病毒感染的戊型肝炎抗原（HBeAg）陰性的患者中。這些自發的“耀斑”是否可以預測乙肝表面抗原（HBsAg）的後續損失尚待確定。
目標：

記錄在慢性HBeAg陰性攜帶者中自發性HBV發作的患者百分比和嚴重程度。
方法：

對HBV數據庫進行的回顧性研究確定並追踪了HBeAg陰性患者的耀斑（ALT> 5x正常）和隨後的HBsAg狀態的生化證據。隨後清除HBsAg的患者與仍保持HBsAg陽性的患者1：1配對。
結果：

在1299名HBeAg陰性患者中隨訪了10.2±6.1年，其中88名（6.8％）發生了自發性HBV發作。在隨後清除HBsAg的患者中有14/115（12.2％）發生了耀斑，而在HBsAg陽性的患者中有4/111（3.6％）相匹配的患者發生了耀斑（p = 0.025）。在兩個研究隊列中，耀斑的嚴重程度相似。在進行多變量分析之後，只有基線時的HBV-DNA水平低才能確定可能隨後清除HBsAg的患者。
結論：

儘管在隨後清除HBsAg的患者中更為常見，但自發性HBV耀斑不能預測隨後的HBsAg清除。
關鍵字：

耀斑;乙肝病毒DNA乙肝抗原乙肝表面抗原乙型肝炎；重新激活

PMID：
    32034604
DOI：
    10.1007 / s10620-020-06125-5