乙型肝炎病毒核心相关抗原的使用，以评估慢性乙型肝炎的

StephenW

J Gastroenterol Hepatol. 2020 Apr 15. doi: 10.1111/jgh.15058. [Epub ahead of print]
Use of Hepatitis B Virus Core Related Antigen to Evaluate Natural History of Chronic Hepatitis B.
Chan HLY1, Yasuda S2, Wong GLH1, Tada T2, Chan CKM1, Kumada T2, Tse YK1, Wong VWS1, Toyoda H2.
Author information

1
    Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.
2
    Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.

Abstract
BACKGROUND AND AIMS:

Hepatitis B core related antigen (HBcrAg) has been shown to correlate with various viral markers in chronic hepatitis B, but its role in defining natural history is not well studied. We aimed to investigate the use of HBcrAg to define different phases of chronic hepatitis B.
METHODS:

Stored residual serum samples from longitudinal cohorts of chronic hepatitis B patients in Hong Kong and Japan were studied. Viral markers were measured in 3 serial serum samples for each patient. Patients were divided into 6 groups for analysis: HBeAg-positive chronic infection (EPI), HBeAg-positive chronic hepatitis (EPH), HBeAg seroconversion (ES), HBeAg-negative chronic hepatitis (ENH), HBeAg-negative chronic infection (ENI) and HBsAg seroclearance (SS).
RESULTS:

166 patients followed up for 100 (76-113) months were included. HBcrAg was correlated with HBV DNA and HBsAg levels in both HBeAg-positive and HBeAg-negative patients. HBcrAg cut-off of ≥6.0 log U/ml could best differentiate HBeAg-positive from HBeAg-negative patients (area under receiver operating characteristic curve [AUROC] 0.99, p<0.001). HBcrAg could not differentiate patients in EPI and EPH phases, but HBcrAg declined dramatically at HBeAg seroconversion. In HBeAg-negative patients, HBcrAg ≥4.0 log U/ml could best differentiate ENH from ENI (AUROC 0.81; p<0.001), with high specificity (81.6%) but only moderate sensitivity (65.7%) at baseline. Undetectable HBcrAg was found in 17%, 63% and 89% patients in ENH, ENI, and SS groups at the last visit, respectively.
CONCLUSIONS:

HBcrAg provides useful information to stage the natural history of chronic hepatitis B, particularly identifying HBeAg-positive patients and HBeAg-negative patients with active disease.

© 2020 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.
KEYWORDS:

Hepatitis B; clinical; Hepatitis B; natural history; Hepatitis B; virology

PMID:
    32293740
DOI:
    10.1111/jgh.15058

StephenW

J胃肠肝素。 2020年4月15日。doi：10.1111 / jgh.15058。 [Epub提前发行]
乙型肝炎病毒核心相关抗原的使用，以评估慢性乙型肝炎的自然病史。
Chan HLY1，Yasuda S2，Wong GLH1，Tada T2，Chan CKM1，Kumada T2，Tse YK1，Wong VWS1，Toyoda H2。
作者信息

1个
    香港中文大学医学与治疗学系，香港。
2
    日本岐阜县大垣市大垣市立医院消化内科。

抽象
背景与目的：

乙型肝炎核心相关抗原（HBcrAg）已被证明与慢性乙型肝炎的各种病毒标志物相关，但其在定义自然病史中的作用尚未得到充分研究。我们旨在研究使用HBcrAg定义慢性乙型肝炎的不同阶段。
方法：

研究了香港和日本的慢性乙型肝炎患者纵向队列中存储的残留血清样本。在每位患者的3个连续血清样本中测量病毒标记物。将患者分为6组进行分析：HBeAg阳性慢性感染（EPI），HBeAg阳性慢性肝炎（EPH），HBeAg血清转化（ES），HBeAg阴性慢性肝炎（ENH），HBeAg阴性慢性感染（ENI）和HBsAg血清清除率（SS）。
结果：

纳入166例患者，随访时间100（76-113）个月。 HBcrAg与HBeAg阳性和HBeAg阴性患者的HBV DNA和HBsAg水平相关。 HBcrAg截止值≥6.0log U / ml可以最好地区分HBeAg阳性和HBeAg阴性患者（接受者工作特征曲线下的面积[AUROC] 0.99，p <0.001）。 HBcrAg无法区分EPI和EPH阶段的患者，但是HBcrAg在HBeAg血清转化时急剧下降。在HBeAg阴性患者中，HBcrAg≥4.0log U / ml可以最佳地区分ENH和ENI（AUROC 0.81; p <0.001），特异性高（81.6％），但基线时敏感性中等（65.7％）。在最后一次访视时，ENH，ENI和SS组的17％，63％和89％的患者分别发现了不可检测的HBcrAg。
结论：

HBcrAg提供有用的信息，以分阶段慢性乙型肝炎的自然病史，尤其是鉴定患有活动性疾病的HBeAg阳性患者和HBeAg阴性患者。

©2020胃肠病学和肝病学杂志和John Wiley＆Sons Australia，Ltd.
关键字：

乙型肝炎；临床;乙型肝炎；自然历史;乙型肝炎；病毒学

PMID：
    32293740
DOI：
    10.1111 / jgh.15058