血脂异常对核苷（酸）类似物治疗慢性乙型肝炎患者E抗原血

StephenW

血脂异常对核苷（酸）类似物治疗慢性乙型肝炎患者E抗原血清转化的影响
夏自强1、居增征2、梁征1、恩典征1、邹卓林3 4、熊升5 6、吴金明7
隶属关系
隶属关系

    1
    温州市人民医院消化内科，温州 325000
    2
    温州医科大学第一附属医院消化内科，温州 325000
    3
    嘉兴学院第一附属医院感染科，嘉兴 314000
    4
    嘉兴市第一医院感染科，嘉兴 314000
    5
    嘉兴学院第一附属医院感染科，嘉兴 314000 [email protected]。
    6
    嘉兴市第一医院感染科，嘉兴 314000 [email protected]。
    7
    温州医科大学第一附属医院消化内科，温州 325000 [email protected]。

    PMID：34717643 DOI：10.1186/s12944-021-01582-x

抽象的

背景：中国血脂异常患病率逐年上升。目前的研究表明，血脂异常会影响丙型肝炎病毒 (HCV) 疗法的抗病毒功效，而最近的研究表明，血清脂质会影响接受聚乙二醇化干扰素-α (Peg IFN-α) 治疗的慢性乙型肝炎 (CHB) 患者的反应率。然而，血脂异常在 CHB 患者中核苷（酸）类似物 (NAs) 疗效中的作用仍不清楚。

方法：对2010年1月至2013年12月在温州医科大学第一附属医院就诊的179例乙型肝炎e抗原（HBeAg）阳性CHB患者的资料进行评估。在这些患者中，68 名被分配到血脂异常组（诊断为 CHB 并伴有血脂异常），111 名被分配到血脂正常组。在 5 年内对所有 CHB 患者进行了以下 3 种治疗策略：拉米夫定 (LAM) 加阿德福韦酯 (ADV) 联合治疗、替比夫定 (LdT) 单药治疗和恩替卡韦 (ETV) 单药治疗。比较两组患者的血清学评估、血液生化、HBV血清学标志物、治疗前HBV DNA及治疗后不同时间点HBeAg血清学转化和病毒学应答情况。计量资料比较采用τ检验，计数资料采用χ2检验。使用二元逻辑回归分析进行相关分析。

结果：血脂异常组第1、2、3、4年HBeAg血清学转换率分别为10.3、13.2、17.6和22.1%，与血脂正常组（11.7、16.2、 18.0 和 33.3%；χ2 分别 = 0.085、0.293、0.004 和 2.601；Ρ > 0.05）。然而，血脂异常组的 HBeAg 血清学转换率在第 5 年显着低于血脂正常组（27.9% vs. 43.2%，χ2 = 4.216，Ρ < 0.05）。单变量逻辑回归分析显示，有和无血清转换的组在组、性别、PTA、ALT、AST、CR 和 LDL-C 方面存在显着差异。多元回归分析表明血脂异常（OR = 1.993，Ρ = 0.038）和男性（OR = 2.317，Ρ = 0.029）是与HBeAg血清学转换相关的危险因素。

结论：在抗病毒治疗期间，血脂异常会影响接受 NAs 治疗的 CHB 患者的 HBeAg 血清学转换，但不影响病毒学应答。

关键词：抗病毒作用；慢性乙型肝炎;血脂异常;核苷（酸）类似物。

© 2021。作者。

StephenW

Effects of dyslipidemia on E antigen seroconversion of patients with chronic hepatitis B treated by nucleoside (acid) analogs
Ziqiang Xia  1 , Juzeng Zheng  2 , Liang Zheng  1 , Endian Zheng  1 , Zhuolin Zou  3   4 , Xiong Sheng  5   6 , Jinming Wu  7
Affiliations
Affiliations

    1
    Department of Gastroenterology, Wenzhou People's Hospital, Wenzhou, 325000, China.
    2
    Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
    3
    Department of Infectious Diseases, The First Affiliated Hospital of Jiaxing College, Jiaxing, 314000, China.
    4
    Department of Infectious Diseases, The First Hospital of Jiaxing, Jiaxing, 314000, China.
    5
    Department of Infectious Diseases, The First Affiliated Hospital of Jiaxing College, Jiaxing, 314000, China. [email protected].
    6
    Department of Infectious Diseases, The First Hospital of Jiaxing, Jiaxing, 314000, China. [email protected].
    7
    Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China. [email protected].

    PMID: 34717643 DOI: 10.1186/s12944-021-01582-x

Abstract

Background: The prevalence of dyslipidemia in China is increasing annually. Current studies suggest that dyslipidemia affects the antiviral efficacy of hepatitis C virus (HCV) therapies, while recent studies suggest that serum lipids influence the response rates of chronic hepatitis B (CHB) patients receiving PEGylated interferon-alpha (Peg IFN-α) treatment. However, the role of dyslipidemia in the efficacy of nucleoside (acid) analogues (NAs) in CHB patients remains unclear.

Methods: From January 2010 to December 2013, data from 179 treatment-naive patients with CHB who were hepatitis B e antigen (HBeAg)-positive and had visited the first affiliated hospital of Wenzhou Medical University were assessed. Of these patients, 68 were assigned to the dyslipidemia group (diagnosed with CHB complicated with dyslipidemia) and 111 to the normolipidemic group. The following 3 treatment strategies were performed for all CHB patients over a 5-year period: lamivudine (LAM) plus adefovir dipivoxil (ADV) combination therapy, telbivudine (LdT) monotherapy, and entecavir (ETV) monotherapy. Serum assessments, blood biochemistry, HBV serological markers, HBV DNA before treatment and HBeAg serological conversion and virological responses at different timepoints after treatment were compared between the two groups. Measurement data were compared by τ tests and enumeration data by χ2 tests. Correlation analysis was performed using binary logistic regression analysis.

Results: The rates of HBeAg seroconversion in the dyslipidemia group at years 1, 2, 3, and 4 were 10.3, 13.2, 17.6, and 22.1%, respectively, which were not significantly lower than those of the normolipidemic group (11.7, 16.2, 18.0 and 33.3%; χ2 = 0.085, 0.293, 0.004, and 2.601, respectively; Ρ > 0.05). However, the rates of HBeAg seroconversion in the dyslipidemia group were significantly lower than those in the normolipidemic group at year 5 (27.9% vs. 43.2%, χ2 = 4.216, Ρ < 0.05). Univariate logistic regression analysis revealed significant differences in group, gender, PTA, ALT, AST, CR, and LDL-C between groups with and without seroconversion. Multivariate regression analysis demonstrated that dyslipidemia (OR = 1.993, Ρ = 0.038) and male gender (OR = 2.317, Ρ = 0.029) were risk factors associated with HBeAg seroconversion.

Conclusions: During antiviral therapy, dyslipidemia affects HBeAg seroconversion in CHB patients treated with NAs, but does not affect the virological response.

Keywords: Antiviral effect; Chronic hepatitis B; Dyslipidemia; Nucleoside (acid) analogs.

© 2021. The Author(s).

StephenW

https://lipidworld.biomedcentral ... 944-021-01582-x.pdf