初治乙型肝炎e抗原阴性的慢性乙型肝炎患者炎症活动的预测

StephenW

Predictors of inflammatory activity in treatment-naive hepatitis B e-antigen-negative patients with chronic hepatitis B infection
Jianhua Hu  1 , Yong Wang  2 , Gongying Jiang  2 , Jie Zheng  2 , Tuxiang Chen  2 , Zhiping Chen  2 , Meifang Yang  1 , Xuan Zhang  1 , Hong Zhao  1 , Lanjuan Li  1
Affiliations
Affiliations

    1
    State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
    2
    Department of Infectious Diseases, People's Hospital of Changshan, Quzhou, Zhejiang, China.

    PMID: 33179557 DOI: 10.1177/0300060520969582

Abstract

Objective: Liver inflammatory activity staging is critical to guide the treatment of chronic hepatitis B virus (CHB) infection. Here, we aimed to identify practical clinical biomarkers of moderate inflammatory activity in hepatitis B e-antigen (HBeAg)-negative CHB patients.

Methods: Treatment-naïve HBeAg-negative CHB patients who underwent liver biopsy at our hospital from 1 January 2013 to 31 December 2016 were enrolled. Markers of inflammatory activity were analyzed using binary logistic regression. The area under the receiver operator characteristic curve (AUROCC) was used to assess diagnostic accuracy.

Results: A total of 106 HBeAg-negative treatment-naive CHB patients were enrolled. According to their METAVIR inflammatory scores, 30.2% of patients were in stage ≥A2. Total triiodothyronine (TT3) and hepatitis B virus (HBV) DNA levels were predictors of moderate inflammatory activity (A ≥ 2). The AUROCCs of TT3 and HBV DNA levels were 0.651 and 0.797, respectively. The optimal cut-off values for TT3 and HBV DNA were 1.755 nmol/L and 4.61 log10 IU/mL, respectively.

Conclusions: A sizable proportion of treatment-naive HBeAg-negative CHB patients required antiviral treatment (30.2%) after undergoing liver biopsy. TT3 and HBV DNA helps identify patients with moderate inflammatory activity (A ≥ 2), potentially reducing the need for liver biopsies and helping guide treatment of CHB patients.

Keywords: Chronic hepatitis B; HBeAg-negative; inflammatory activity; noninvasive biomarkers; thyroid hormone; total triiodothyronine.

StephenW

初治乙型肝炎e抗原阴性的慢性乙型肝炎患者炎症活动的预测因子
胡建华1，王勇2，姜公英2，郑洁2，陈土祥2，陈志平2，杨美芳1，张璇1，赵宏1，李兰娟1
隶属关系
隶属关系

    1个
    浙江大学医学院附属第一医院传染病诊断与治疗国家重点实验室，国家传染病临床研究中心，传染病诊断与治疗协同创新中心，浙江杭州。
    2
    浙江省Qu州市常山市人民医院传染病科。

    PMID：33179557 DOI：10.1177 / 0300060520969582

抽象

目的：肝炎活动分期对于指导慢性乙型肝炎病毒（CHB）感染的治疗至关重要。在这里，我们旨在确定乙型肝炎电子抗原（HBeAg）阴性的CHB患者中度炎症活动的实用临床生物标志物。

方法：纳入2013年1月1日至2016年12月31日在我院接受肝活检的初治HBeAg阴性CHB患者。使用二元逻辑回归分析分析炎症活动的标记。接收器操作员特征曲线（AUROCC）下的区域用于评估诊断准确性。

结果：共纳入106例未接受HBeAg阴性治疗的CHB患者。根据他们的METAVIR炎症评分，30.2％的患者处于≥A2期。总的三碘甲状腺素（TT3）和乙型肝炎病毒（HBV）DNA水平是中度炎症活动的预测因子（A≥2）。 TT3和HBV DNA水平的AUROCC分别为0.651和0.797。 TT3和HBV DNA的最佳临界值分别为1.755 nmol / L和4.61 log10 IU / mL。

结论：相当大比例的未经治疗的HBeAg阴性CHB患者在接受肝活检后需要抗病毒治疗（30.2％）。 TT3和HBV DNA有助于鉴定中度炎症活动（A≥2）的患者，可能减少对肝活检的需要，并有助于指导CHB患者的治疗。

关键字：慢性乙型肝炎； HBeAg阴性；炎症活动非侵入性生物标志物；甲状腺激素总三碘甲状腺素。

StephenW

https://journals.sagepub.com/doi/pdf/10.1177/0300060520969582