hbsag水平可用于排除hbeag阳性慢性乙型肝炎的肝硬化：sonic-b研

StephenW

J Infect Dis. 2020 Apr 21. pii: jiaa192. doi: 10.1093/infdis/jiaa192. [Epub ahead of print]
hbsag levels can be used to rule out cirrhosis in hbeag positive chronic hepatitis b: results from the sonic-b study.
Sonneveld MJ1, Hansen BE2,3, Brouwer WP1, Chan HL4, Piratvisuth T5, Jia JD6, Zeuzem S7, Chien RN8, de Knegt RJ1, Wat C9, Pavlovic V9, Gaggar A10, Xie Q11, Buti M12, de Man RA1, Janssen HLA1,2; SONIC-B Study group.
Author information

1
    Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
2
    Department of Toronto Centre for Liver Disease, University Health Network, Toronto, Canada.
3
    Department of IHPME, University of Toronto, Toronto, Canada.
4
    Department of Medicine and Therapeutics and Institute of Digestive Disease, the Chinese University of Hong Kong, Hong Kong SAR, China.
5
    NKC Institute of Gastroenterology and Hepatology, Songklanagarind Hospital, Prince of Songkla University, Hat Yai, Thailand.
6
    Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
7
    Medical Clinic 1, Johann Wolfgang Goethe University Medical Center, Frankfurt, Germany.
8
    Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan.
9
    Roche Product Ltd, Welwyn Garden City, UK.
10
    Gilead Sciences, Foster City, CA, USA.
11
    Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
12
    Unit, Hospital Universitari Vall d'Hebron and CIBEHED del Instituto Carlos III, Barcelona, Spain.

Abstract
BACKGROUND & AIMS:

Serum HBsAg levels correlate with the duration of chronic HBV infection and may predict the extent of hepatic fibrosis.
METHODS:

We analysed data from the SONIC-B database, which contains data from 8 global randomized trials and two large hepatology centers. Relationship between HBsAg levels and presence of significant fibrosis (Ishak 3-4) or cirrhosis (Ishak 5-6) were explored and clinically relevant cut-offs were identified to rule out cirrhosis.
RESULTS:

The dataset included 2779 patients; 1866 HBeAg-positive; 322 with cirrhosis. Among HBeAg-positive patients, lower HBsAg levels were associated with higher rates of significant fibrosis (Odds Ratio [OR] 0.419, P<0.001) and cirrhosis (OR 0.435, p<0.001). No relationship was observed among HBeAg-negative patients. Among HBeAg-positive patients, genotype specific HBsAg cut-offs had excellent NPVs (>97%) and low misclassification rates (≤7.1%) and may therefore have utility in ruling out cirrhosis. Diagnostic performance of the HBsAg cut-offs was comparable among patients in whom cirrhosis could not be ruled out with FIB-4.
CONCLUSIONS:

HBV genotype specific HBsAg cut-offs may have utility in ruling out presence of cirrhosis in HBeAg-positive patients with genotypes B, C and D and can be an adjunct to FIB-4 to reduce the need for further testing.

© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.
KEYWORDS:

HBsAg; cirrhosis; fibrosis; hepatitis B

PMID:
    32318704
DOI:
    10.1093/infdis/jiaa192

StephenW

感染杂志2020年4月21日。pii：jiaa192。 doi：10.1093 / infdis / jiaa192。 [Epub提前发行]
hbsag水平可用于排除hbeag阳性慢性乙型肝炎的肝硬化：sonic-b研究的结果。
Sonneveld MJ1，Hansen BE2,3，Brouwer WP1，Chan HL4，Piratvisuth T5，Jia JD6，Zeuzem S7，Chien RN8，de Knegt RJ1，Wat C9，Pavlovic V9，Gaggar A10，Xie Q11，Buti M12，de Man RA1，Janssen HLA1​​,2; SONIC-B研究组。
作者信息

1个
    荷兰鹿特丹伊拉斯姆斯MC大学医学中心胃肠病学和肝病学系。
2
    加拿大多伦多大学健康网络多伦多肝病中心系。
3
    加拿大多伦多大学多伦多大学国际水文计划系。
4
    香港中文大学，香港特别行政区医学与治疗学系和消化系统疾病研究所。
5
    泰国合艾宋卡王子大学Songklanagarind医院NKC胃肠病和肝病研究所。
6
    首都医科大学附属北京友谊医院肝脏研究中心，北京
7
    德国法兰克福约翰·沃尔夫冈·歌德大学医学中心1号医学诊所。
8
    台湾台北市长庚大学医学院长庚纪念医院肝脏研究室。
9
    英国韦林花园城罗氏产品有限公司。
10
    美国加利福尼亚州福斯特城的吉利德科学公司。
11
    上海交通大学医学院附属瑞金医院传染病科，上海
12
    西班牙巴塞罗纳瓦勒德希伯伦大学医院和卡洛斯三世学院院长单位。

抽象
背景与目的：

血清HBsAg水平与慢性HBV感染的持续时间相关，并且可以预测肝纤维化的程度。
方法：

我们分析了来自SONIC-B数据库的数据，该数据库包含来自8个全球随机试验和两个大型肝病中心的数据。探讨了HBsAg水平与严重纤维化（Ishak 3-4）或肝硬化（Ishak 5-6）的存在之间的关系，并确定了临床相关的临界值以排除肝硬化。
结果：

数据集包括2779名患者； 1866年HBeAg阳性； 322患有肝硬化。在HBeAg阳性患者中，较低的HBsAg水平与显着纤维化（几率[OR] 0.419，P <0.001）和肝硬化（OR 0.435，p <0.001）的发生率较高相关。在HBeAg阴性患者中未发现相关性。在HBeAg阳性患者中，基因型特异的HBsAg临界值具有极好的NPV（> 97％）和较低的误分类率（≤7.1％），因此可用于排除肝硬化。在不能用FIB-4排除肝硬化的患者中，HBsAg临界值的诊断性能相当。
结论：

HBV基因型特异的HBsAg临界值可能有助于排除基因型B，C和D的HBeAg阳性患者的肝硬化，并且可以作为FIB-4的辅助药物以减少进一步检测的需要。

©2020作者。牛津大学出版社，美国传染病学会出版。
关键字：

乙肝表面抗原肝硬化纤维化乙肝

PMID：
    32318704
DOI：
    10.1093 / infdis / jiaa192