血清HBV RNA水平可預測慢性HBV感染患者的明顯肝纖維化

StephenW

Serum HBV RNA levels predict significant liver fibrosis in patients with chronic HBV infection
Chenlu Huang #  1 , Qiang Li #  1 , Wei Xu #  1 , Qianqian Wang  1 , Qiankun Hu  1 , Xiaonan Zhang  2 , Yuxian Huang  1 , Liang Chen  1   3
Affiliations
Affiliations

    1
    Department of Liver Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
    2
    Research Unit, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
    3
    Corresponding author.

#
Contributed equally.

    PMID: 33002408

Abstract

Background and aim: Recently, several studies demonstrated that serum HBV RNA levels were associated with liver disease progression in patients with chronic hepatitis B virus (HBV) infection. This study aimed to determine whether serum HBV RNA levels were correlated with liver fibrosis.

Methods: 319 treatment-naïve patients with chronic HBV infection were included. The correlation between serum HBV RNA levels and liver histological fibrosis stages was analyzed, and calculations of the area under the receiver operating curve (AUROC) were performed for serum HBV RNA.

Results: Serum HBV RNA levels were an independent predictor for significant liver fibrosis both in HBeAg-positive patients (OR=0.514, p<0.001) and HBeAg-negative patients (OR=3.574, p<0.001). In 153 HBeAg-positive patients, HBV RNA had a better diagnostic performance than APRI and FIB-4 (AUROC of 0.77, 0.66, and 0.66 for HBV RNA, APRI, and FIB-4, respectively; p=0.045 for HBV RNA vs. APRI; p=0.043 for HBV RNA vs. FIB-4) for the diagnosis of significant liver fibrosis. In 166 HBeAg-negative patients, HBV RNA also had a better diagnostic performance than APRI and FIB-4 (AUROC of 0.78, 0.68, and 0.62 for HBV RNA, APRI, and FIB-4, respectively; p=0.036 for HBV RNA vs. APRI; p=0.003 for HBV RNA vs. FIB-4) for the diagnosis of significant liver fibrosis.

Conclusion: Serum HBV RNA levels were a more accurate noninvasive test than APRI and FIB-4 for the diagnosis of significant liver fibrosis in treatment-naïve patients with chronic HBV infection.

StephenW

血清HBV RNA水平可預測慢性HBV感染患者的明顯肝纖維化
黃晨鹿1，李強1，徐偉1，王倩倩1，胡倩坤1，張曉楠2，黃玉賢1，梁亮1 3
隸屬關係
隸屬關係

    1個
    復旦大學附屬上海公共衛生臨床中心肝病科，上海201508
    2
    復旦大學上海公共衛生臨床中心研究室，上海201508
    3
    通訊作者。

＃
貢獻均等。

    PMID：33002408

抽象

背景與目的：最近，一些研究表明，慢性乙型肝炎病毒（HBV）感染患者的血清HBV RNA水平與肝臟疾病的進展有關。這項研究旨在確定血清HBV RNA水平是否與肝纖維化相關。

方法：包括319名未接受過治療的慢性HBV感染患者。分析了血清HBV RNA水平與肝臟組織學纖維化分期之間的相關性，並對血清HBV RNA進行了接收器工作曲線下面積的計算（AUROC）。

結果：血清HBV RNA水平是HBeAg陽性患者（OR = 0.514，p <0.001）和HBeAg陰性患者（OR = 3.574，p <0.001）嚴重肝纖維化的獨立預測因子。在153位HBeAg陽性患者中，HBV RNA的診斷性能優於APRI和FIB-4（對於HBV RNA，APRI和FIB-4，AUROC分別為0.77、0.66和0.66；對於HBV RNA，p = 0.045。 APRI； HBV RNA與FIB-4的p = 0.043，以診斷出明顯的肝纖維化。在166名HBeAg陰性患者中，HBV RNA的診斷性能也優於APRI和FIB-4（AUROC分別為HBV RNA，APRI和FIB-4的0.78、0.68和0.62； HBV RNA的p = 0.036 APRI； HBV RNA與FIB-4的p = 0.003，以診斷出明顯的肝纖維化。

結論：對於未接受過治療的慢性HBV感染患者，血清HBV RNA水平是一種比APRI和FIB-4更準確的非侵入性測試，用於診斷明顯的肝纖維化。