抗-HBc IgG水平：核苷类似物诱导的HBeAg血清清除的慢性乙型肝

StephenW

Anti-HBc IgG Levels: A Predictor of HBsAg Seroclearance in Chronic Hepatitis B Patients with Nucleos(t)ide Analogue-Induced HBeAg Seroclearance
Saein Kim #  1 , Sunghwan Yoo #  1 , Jung Il Lee  1 , Sora Kim  1 , Hye Young Chang  1 , Dokyun Kim  2 , Seok Hoon Jeong  2 , Kwan Sik Lee  1 , Hyun Woong Lee  3
Affiliations
Affiliations

    1
    Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Korea.
    2
    Department of Laboratory Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Korea.
    3
    Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Korea. [email protected].

#
Contributed equally.

    PMID: 33517556 DOI: 10.1007/s10620-021-06845-2

Abstract

Background/aims: We investigated the efficiency of the indirect ratio of anti-HBc IgG at predicting HBsAg seroclearance in patients with nucleos(t)ide analogue (NA)-induced HBeAg seroclearance.

Methods: We performed a retrospective study that included 366 chronic hepatitis B patients (March 2007 to December 2016) at a single tertiary hospital. These patients were HBsAg seropositive, and experienced NA-induced HBeAg seroclearance. The indirect ratio of light absorbance of anti-HBc IgG levels were measured with chemiluminescent microparticle immunoassay using the Architect Anti-HBc assay (Abbott Laboratories, IL, USA) as a qualitative method prior to antiviral therapy. We calculated the cumulative incidences of HBsAg seroclearance based on the anti-HBc IgG levels.

Results: After a 10-year follow-up, 48 patients experienced HBsAg seroclearance (13.1%). Thirty-three of 179 patients who had an indirect ratio of light absorbance of anti-HBc IgG < 11 RLU (relative light unit) showed HBsAg seroclearance (18.4%); 15 of 187 patients who had an indirect ratio of light absorbance of anti-HBc IgG ≥ 11 RLU showed HBsAg seroclerance (8.0%) (p = 0.003). In multivariate analysis, age, and ALT at the time of HBeAg seroclearance were predictors of HBsAg seroclearance. Especially, the relative risk of HBsAg seroclearance in patients with baseline anti-HBc IgG levels < 11 RLU was 2.213 (95% CI, 1.220-4.014), compared to that in patients with higher levels of anti-HBc IgG at baseline (p = 0.009).

Conclusion: Using an indirect method for anti-HBc IgG levels, baseline anti-HBc IgG levels (< 11RLU), age (≥ 50 years), and ALT (≥ 40 IU/L) might be associated with HBsAg seroclearance in patients with NA-induced HBeAg seroclearance.

Keywords: Hepatitis B core antigen; Hepatitis B e antigen; Hepatitis B surface antigen; Hepatitis B virus.

StephenW

抗-HBc IgG水平：核苷类似物诱导的HBeAg血清清除的慢性乙型肝炎患者HBsAg血清清除的预测因子
Saein Kim＃1，Sunghwan Yoo＃1，Lee Jung Il Lee，Kim Sora 1，Hye Young Chang 1，Kim Dokyun 2，Seok Hoon Jeong 2，Kwan Sik Lee 1，Hyun Woong Lee 3
隶属关系
隶属关系

    1个
    延世大学医学院江南遣散医院内科，首尔江南区恩州路211，韩国06273
    2
    延世大学医学院江南遣散医院检验医学科，首尔江南区恩州路211，韩国06273。
    3
    延世大学医学院江南遣散医院内科，首尔江南区恩州路211，韩国06273 [email protected]。

＃
贡献均等。

    PMID：33517556 DOI：10.1007 / s10620-021-06845-2

抽象

背景/目的：我们调查了抗-HBc IgG间接比率在预测核苷酸（t）类似物（NA）诱导的HBeAg血清清除患者中HBsAg血清清除的效率。

方法：我们在一家三级医院进行了一项回顾性研究，纳入了366例慢性乙型肝炎患者（2007年3月至2016年12月）。这些患者均为HBsAg血清阳性，并经历过NA诱导的HBeAg血清清除。抗HBc IgG水平的吸光度间接比值是通过化学发光微粒免疫测定法进行的，该测定方法是在抗病毒治疗之前使用Architect Anti-HBc测定法（Abbott Laboratories，IL，USA）作为定性方法进行的。我们根据抗HBc IgG水平计算了HBsAg血清清除的累积发生率。

结果：经过10年的随访，有48例患者发生了HBsAg血清清除（13.1％）。 179名间接抗-HBc IgG吸光率小于11 RLU（相对光单位）的患者中有33例显示HBsAg血清清除率（18.4％）； 187名抗-HBc IgG≥11 RLU的吸光度间接比值的患者中有15名显示HBsAg血清耐受性（8.0％）（p = 0.003）。在多变量分析中，HBeAg血清清除时的年龄和ALT是HBsAg血清清除的预测因素。特别是，基线抗-HBc IgG水平<11 RLU的患者中HBsAg血清清除的相对风险为2.213（95％CI，1.220-4.014），而基线时抗-HBc IgG水平较高的患者（p = 0.009）。

结论：使用间接方法检测抗-HBc IgG水平，NA患者的基线抗-HBc IgG水平（<11RLU），年龄（≥50岁）和ALT（≥40 IU / L）可能与HBsAg血清清除有关引起的HBeAg血清清除。

关键词：乙型肝炎核心抗原乙型肝炎e抗原；乙型肝炎表面抗原；乙型肝炎病毒。

StephenW

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