乙型肝炎表面抗原水平与非活动性乙型肝炎携带者中的自发

StephenW

J Clin Gastroenterol. 2020 Feb 11. doi: 10.1097/MCG.0000000000001324. [Epub ahead of print]
Hepatitis B Surface Antigen Levels Are Related to Spontaneous Hepatitis B Surface Antigen Seroconversion in Inactive Hepatitis B Carriers.
Wu CF1, Fong TM1, Wu SS1, Saab S2,3,4.
Author information
Abstract
BACKGROUND:

The cure for hepatitis B is defined as the hepatitis B surface antigen (HBsAg) seroclearance and/or seroconversion. Predictors of spontaneous seroconversion are not well described. The objective of this study is to identify predictors of spontaneous HBsAg seroconversion from community practice.
METHODS:

We performed a matched analysis of patients who HBsAg seroconverted (cases) and patients who did not HBsAg seroconvert (control) in a 1:5 ratio according to date of clinic visit between 2014 and 2019 in a large community practice situated in Los Angeles area. Baseline laboratory and clinical data were collected. Univariate analysis and 2-sided t tests were performed, χ test for proportions, and logistic regression.
RESULTS:

We identified 14 cases and 70 controls. The mean (±SD) ages of the cases and controls were 53.6 (±12.2) and 49.5 (±13.1), respectively (P=0.45). Most patients were women, and all patients were of Asian descent. There were statistically significant mean (±SD) baseline differences between cases and controls in HBsAg titers (459.8±311.0 and 782.0±393.3 IU/mL, P=0.01) and alanine aminotransferase (ALT) values (17.6±4.4 and 25.1±16.7 IU/mL, P<0.01), respectively. Baseline hepatitis B virus DNA and other pertinent laboratory values did not differ between cases and controls. Eleven of 14 cases (79%) and 11 of 70 controls (16%) baseline HBsAg titers were <1000 IU/mL (P<0.01). The results of a logistic regression demonstrated that HBsAg titers and ALT values were predictor variables for HBsAg seroconversion (P=0.01 and <0.01, respectively).
CONCLUSIONS:

Spontaneous HBsAg seroclearance and seroconversion is an uncommon event in patients with chronic hepatitis B. The most important predictors of seroconversion are HBsAg titers<1000 IU/mL and low baseline ALT values.

PMID:
    32049690
DOI:
    10.1097/MCG.0000000000001324

StephenW

J临床胃肠病学。 2020年2月11日。doi：10.1097 / MCG.0000000000001324。 [Epub提前发行]
乙型肝炎表面抗原水平与非活动性乙型肝炎携带者中的自发性乙型肝炎表面抗原血清转化有关。
Wu CF1，Fong TM1，Wu SS1，Saab S2、3、4。
作者信息
抽象
背景：

乙型肝炎的治愈定义为乙型肝炎表面抗原（HBsAg）血清清除和/或血清转化。没有很好地描述自发血清转化的预测因素。这项研究的目的是从社区实践中确定自发性HBsAg血清转化的预测因素。
方法：

我们根据2014年至2019年之间在洛杉矶地区的大型社区实践中的门诊日期，以1：5的比例对HBsAg血清转化的患者（病例）和未进行HBsAg血清转化（对照）的患者进行了匹配分析。收集基线实验室和临床数据。进行了单变量分析和两面t检验，对比例进行了χ检验，并进行了逻辑回归。
结果：

我们确定了14个病例和70个对照。病例和对照组的平均年龄分别为53.6（±12.2）和49.5（±13.1）（P = 0.45）。大多数患者是女性，所有患者均为亚洲血统。病例与对照组之间的HBsAg滴度（459.8±311.0和782.0±393.3 IU / mL，P = 0.01）和丙氨酸转氨酶（ALT）值（17.6±4.4和25.1±16.7 IU）之间存在统计学意义的平均（±SD）基线差异/mL，P<0.01）。基线乙型肝炎病毒DNA和其他相关实验室值在病例与对照之间没有差异。 14例基线HBsAg滴度中的11例（79％）和70例对照中的11例（16％）<1000 IU / mL（P <0.01）。 Logistic回归结果表明，HBsAg滴度和ALT值是HBsAg血清转化的预测变量（分别为P = 0.01和<0.01）。
结论：

在慢性乙型肝炎患者中，自发性HBsAg血清清除和血清转化是罕见的事件。血清转化的最重要预测指标是HBsAg滴度<1000 IU / mL和基线ALT值低。

PMID：
    32049690
DOI：
    10.1097 / MCG.0000000000001324