血清乙型肝炎核心相关抗原水平可将中度病毒载量的慢性乙

StephenW

Serum hepatitis B core-related antigen level stratifies risk of disease progression in chronic hepatitis B patients with intermediate viral load
Tai-Chung TsengChun-Jen LiuYang Wan-TingYang Wan-TingJia-Horng KaoJia-Horng Kao

    January 2021Alimentary Pharmacology & Therapeutics

    DOI: 10.1111/apt.16266
Abstract
Background: Patients with chronic hepatitis B virus (HBV) infection are at risk of developing liver disease. Serum hepatitis B core-related antigen (HBcrAg) is a new biomarker for intrahepatic templates for HBV replication. Aim: To explore whether a high HBcrAg level is associated with increased risk of cirrhosis, especially in patients with intermediate viral load (HBV DNA 2000-19 999 IU/mL) due to their moderate risk of disease progression. Methods: A total of 1673 treatment-naïve, non-cirrhotic patients with negative hepatitis B e antigen (HBeAg) and alanine aminotransferase (ALT) level <40 U/L at baseline were enrolled. We explored the relationship between baseline levels of HBcrAg and cirrhosis development in all patients, and whether a higher HBcrAg level (<10 vs ≥10 KU/mL) was associated with an increased risk of disease progression in those with intermediate viral load. Results: Of the 1673 patients, 104 developed cirrhosis after a mean follow-up of 15.9 years. Higher HBcrAg levels were associated with increased incidence of cirrhosis, cirrhosis-related complications, and liver-related death. In 445 patients with intermediate viral load, the cirrhosis risk stratified by HBcrAg level of 10 KU/mL yielded a hazard ratio of 3.22 (95% CI: 1.61-6.47). The risk stratification remained significant when exploring other pre-cirrhosis endpoints, including HBeAg-negative hepatitis, hepatitis flare, and HBV DNA >20 000 IU/mL after 3 years of follow-up. Conclusions: In HBeAg-negative patients with normal ALT levels, higher HBcrAg levels are associated with increased risk of cirrhosis. Among those with intermediate viral load, HBcrAg <10 KU/mL defines a low-risk group for disease progression.

StephenW

血清乙型肝炎核心相关抗原水平可将中度病毒载量的慢性乙型肝炎患者的疾病进展风险分层
台中市长陈春仁刘洋万汀杨万汀贾嘉H高嘉嘉or高

    2021年1月，基础药理学与治疗学

    DOI：10.1111 / apt.16266
抽象
背景：患有慢性乙型肝炎病毒（HBV）的患者有患肝病的风险。血清乙肝核心相关抗原（HBcrAg）是用于HBV复制的肝内模板的新生物标记。目的：探讨高HBcrAg水平是否与肝硬化风险增加有关，尤其是由于中度疾病进展风险而具有中等病毒载量（HBV DNA 2000-19 999 IU / mL）的患者。方法：总共纳入了1673例初治，非肝硬化，基线时小于40 U / L的乙型肝炎e抗原（HBeAg）和丙氨酸转氨酶（ALT）的患者。我们探讨了所有患者中HBcrAg基线水平与肝硬化发展之间的关系，以及中度病毒载量者中更高的HBcrAg水平（<10 vs≥10KU / mL）是否与疾病进展风险增加相关。结果：在1673名患者中，有104名在平均随访15.9年后发展为肝硬化。较高的HBcrAg水平与肝硬化，肝硬化相关并发症和肝相关死亡的发生率增加相关。在445名中度病毒载量患者中，以HBcrAg水平为10 KU / mL分层的肝硬化风险产生的危险比为3.22（95％CI：1.61-6.47）。探索其他肝硬化前终点时（包括HBeAg阴性肝炎，肝炎爆发和HBV DNA> 20000 IU / mL），风险分层仍然很重要。结论：在ALT水平正常的HBeAg阴性患者中，较高的HBcrAg水平与肝硬化风险增加相关。在中等病毒载量的人群中，HBcrAg <10 KU / mL定义为疾病进展的低风险人群。