定量乙肝表面抗原检测在乙肝社区筛查中的有用性

StephenW

Usefulness of quantitative hepatitis B surface antigen testing in hepatitis B community-based screening
Kao-Chi Chang  1 , Chih-Yi Lee  2 , Te-Sheng Chang  3 , Chao-Hung Hung  4 , Wei-Ming Chen  1 , Mei-Yen Chen  5 , Tung-Jung Huang  6 , Wen-Nan Chiu  7 , Jing-Hong Hu  7 , Yu-Chih Lin  8 , Wei-Cheng Huang  9 , Nien-Tzu Hsu  10 , Sheng-Nan Lu  11
Affiliations
Affiliations

    1
    Division of Hepatology and Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.
    2
    Department of Laboratory Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.
    3
    Division of Hepatology and Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan; Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Yunlin, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
    4
    Department of Internal Medicine, Division of Hepato-Gastroenterology, Kaohsiung Chang Gung Memorial Hospital, Taiwan.
    5
    College of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan.
    6
    Division of Thoracic Medicine, Chang Gung Memorial Hospital, Yunlin, Taiwan.
    7
    Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Yunlin, Taiwan.
    8
    Division of Family Medicine, Chang Gung Memorial Hospital, Yunlin, Taiwan.
    9
    Department of Geriatric, Chang Gung Memorial Hospital, Chiayi, Taiwan.
    10
    Biostatistics and Bioinformatics Center of Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
    11
    Department of Internal Medicine, Division of Hepato-Gastroenterology, Kaohsiung Chang Gung Memorial Hospital, Taiwan; Biostatistics and Bioinformatics Center of Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan. Electronic address: [email protected].

    PMID: 32896456 DOI: 10.1016/j.jfma.2020.08.031

Abstract

Background/purpose: Low viral load (LVL) of hepatitis B virus (HBV) is a predictor of chronic HBV infection. However, the usefulness of quantitative hepatitis B surface antigen (qHBsAg) in predicting LVL in community-based screening has not been well studied. We aimed to measure the prevalence of LVL in HBV carriers and validate the efficacy of qHBsAg in predicting LVL.

Methods: This community-based screening study was conducted in Taiwan. HBV DNA was assayed in HBsAg carriers. Participants were randomized to training and validation sets to determine the ability of qHBsAg to predict LVL. Receiver operating characteristic curves were used to identify the best cutoff values in the training set.

Results: Among the 2919 participants, 359 (12.2%) were HBsAg carriers. There were 132 and 137 carriers in the training and validation sets, respectively. Significant correlations were found between qHBsAg and HBV DNA in both training and validation sets. Thirty and 29 participants with qHBsAg <8 IU/mL in the training and validation sets, respectively, had LVL. Using 8 IU/mL as the cutoff, negative predictive value (NPV) of qHBsAg for HBV DNA levels >2000 IU/mL was 100%. The best cutoff level of qHBsAg to predict HBV LVL was 200 IU/mL, with a sensitivity, specificity, and accuracy of 75.0%, 76.1%, and 75.8%, respectively, in the training set. The positive predictive value and NPV were 70.0% and 77.9%, respectively, in the validation set.

Conclusion: Approximately 60% of HBsAg carriers had HBV LVL, and qHBsAg <8 IU/mL accurately predicts LVL. This quantitative test provides additional information for community-based screening.

Keywords: Community-based screening tool; HBV DNA; Hepatitis B virus; Quantitative hepatitis B surface antigen.

Copyright © 2020 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

StephenW

定量乙肝表面抗原检测在乙肝社区筛查中的有用性
张高智1，李智怡2，张德胜3，洪朝红4，陈维明1，陈美颜5，黄东荣6，邱文男7，景静洪湖7，林玉枝8，黄维成9，徐念慈10，吕圣南11
隶属关系
隶属关系

    1个
    台湾嘉义长庚纪念医院内科肝病与消化内科。
    2
    台湾嘉义市长庚纪念医院检验科。
    3
    台湾嘉义长庚纪念医院内科肝病消化科；台湾云林长庚纪念医院消化内科；长庚大学医学院医学院，台湾桃园。
    4
    台湾高雄市长庚纪念医院肝消化内科内科。
    5
    长庚科技大学护理学院，台湾嘉义。
    6
    台湾云林市长庚纪念医院胸腔内科。
    7
    台湾云林长庚纪念医院消化内科。
    8
    台湾云林长庚纪念医院家庭医学科。
    9
    台湾嘉义长庚纪念医院老年科
    10
    台湾高雄市高雄市长庚纪念医院生物统计学与生物信息学中心。
    11
    台湾高雄长庚纪念医院肝肠胃科内科；台湾高雄市高雄市长庚纪念医院生物统计学与生物信息学中心。电子地址：[email protected]。

    PMID：32896456 DOI：10.1016 / j.jfma.2020.08.031

抽象

背景/目的：乙型肝炎病毒（HBV）的低病毒载量（LVL）是慢性HBV感染的预兆。但是，在基于社区的筛查中，定量乙型肝炎表面抗原（qHBsAg）在预测LVL中的有用性尚未得到很好的研究。我们旨在测量HBV携带者中LVL的患病率，并验证qHBsAg预测LVL的功效。

方法：这项基于社区的筛查研究在台湾进行。在HBsAg携带者中检测HBV DNA。参与者被随机分为训练和验证集，以确定qHBsAg预测LVL的能力。接收器工作特性曲线用于确定训练集中的最佳截止值。

结果：在2919名参与者中，有359名（12.2％）是HBsAg携带者。训练和验证集中分别有132和137个载体。在训练和验证组中均发现了qHBsAg和HBV DNA之间的显着相关性。在训练和验证组中分别有30名和29名qHBsAg <8 IU / mL的参与者患有LVL。使用8 IU / mL作为临界值，qHBsAg对HBV DNA水平> 2000 IU / mL的阴性预测值（NPV）为100％。在训练集中，预测HBV LVL的最佳qHBsAg截止水平为200 IU / mL，敏感性，特异性和准确性分别为75.0％，76.1％和75.8％。在验证集中，阳性预测值和NPV分别为70.0％和77.9％。

结论：大约60％的HBsAg携带者具有HBV LVL，而qHBsAg <8 IU / mL可以准确预测LVL。该定量测试为基于社区的筛查提供了更多信息。

关键字：基于社区的筛查工具； HBV DNA；乙型肝炎病毒;定量乙肝表面抗原。

版权所有©2020福尔摩沙医学协会。由Elsevier B.V.发布。保留所有权利。

StephenW

https://www.sciencedirect.com/sc ... 20304058?via%3Dihub

乙肝人1949

其实这个论文写了一半，(治疗方而言)，检查出优势人群加干扰素诚下

StephenW

这项研究的目的是了解定量HBsAg检测能否取代定性HBsAg检测和hbvdna检测。

"HBV DNA检测在基于社区的筛查中的使用非常有限，因为它昂贵且需要合适的实验室设备和技术人员。 所有用于预测HBV DNA的HBsAg临界值分别为8、20或200 IU / mL，均小于250 IU / mL，可以在当地诊所或医院轻松进行评估而无需稀释。 换句话说，没有稀释的定量检测与传统的定性检测具有相似的成本，并且可以满足预测HBV DNA水平的需求。"
The use of HBV DNA tests in community-based screening is very limited, because it is expensive and requires suitable laboratory equipment and technicians. The HBsAg cutoff values of 8, 20, or 200 IU/mL, which are all used to predict HBV DNA, are all <250 IU/mL and can be easily evaluated in local clinics or hospitals without dilution. In other words, quantitative testing with no dilution has similar costs to the traditionally used qualitative testing and can meet the demand of predicting the HBV DNA level."