血清乙型肝炎核心相关抗原作为慢性乙型肝炎乙型肝炎e抗原

StephenW

血清乙型肝炎核心相关抗原作为慢性乙型肝炎乙型肝炎e抗原血清转换的替代标志物
池秀美 1 , 王小梅 1 , 王忠风 1 , 吴瑞红 1 , 高秀珠 1 , 徐红琴 1 , 丁艳华 2 , 牛骏奇 3
隶属关系
隶属关系

    1
    吉林大学第一医院人畜共患病研究教育部重点实验室肝病科，吉林省长春130021
    2
    吉林大学第一医院I期临床试验组，吉林省长春130021
    3
    吉林大学第一医院人畜共患病研究教育部重点实验室肝病科，吉林省长春130021 [email protected]。

    PMID：34790015 PMCID：PMC8567480 DOI：10.3748/wjg.v27.i40.6927

抽象的

背景：定量乙型肝炎核心相关抗原（qHBcrAg）与肝内乙型肝炎病毒（HBV）共价闭合环状DNA（cccDNA）的相关性优于HBV DNA或乙型肝炎e抗原（HBeAg），但其相关性仍缺乏数据。临床应用。

目的：目的是调查慢性乙型肝炎患者的血清 qHBcrAg 水平，并评估血清 qHBcrAg 与前基因组 RNA（pgRNA）、cccDNA 和 HBeAg 血清转换的相关性。

方法：本研究是对 2014 年 7 月至 2019 年 6 月期间接受基于聚乙二醇干扰素与核苷（酸）类似物（NUC）治疗的两项多中心随机对照临床试验（NCT03509688 和 NCT03546530）进行经皮肝活检的患者的二次分析。测量了血清 qHBcrAg、pgRNA、HBV DNA、乙型肝炎核心抗原、HBeAg、肝脏 cccDNA 和 HBV DNA。分析了血清 qHBcrAg 与其他生物标志物的相关性。

结果：共纳入139例患者。基线时平均 qHBcrAg 水平为 5.32 ± 1.18 log10 U/mL，并且在治疗期间下降（所有 P < 0.0001）。血清 qHBcrAg 水平与 pgRNA (r = 0.597, P < 0.0001) 和 cccDNA (r = 0.527, P < 0.0001) 水平呈正相关。基线时血清 qHBcrAg 水平与肝内 HBV DNA 水平的相关性较弱但显着（r = 0.399，P < 0.0001）。 HBcrAg 预测 HBeAg 血清学转换，接受者操作特征曲线下面积在 24 周时为 0.788，在 48 周时为 0.825。第 24 周和第 48 周的 Log HBcrAg 与 HBeAg 血清学转换独立相关 [比值比 (OR) = 2.402，95% 置信区间 (CI)：1.314-4.391，P = 0.004； OR = 3.587，95% CI：1.315-9.784，P = 0.013]。

结论：血清 HBcrAg 水平与 HBV 病毒学标志物相关，可用于预测 HBeAg 血清学转换。

关键词：相关性；检测；乙型肝炎核心抗原；乙型肝炎病毒;乙型肝炎病毒DNA；肝活检；前基因组RNA；定量乙肝核心相关抗原；接收器操作特性；血清转化。

©The Author(s) 2021. 由百事登出版集团有限公司出版。保留所有权利。

StephenW

Serum hepatitis B core-related antigen as a surrogate marker of hepatitis B e antigen seroconversion in chronic hepatitis B
Xiu-Mei Chi  1 , Xiao-Mei Wang  1 , Zhong-Feng Wang  1 , Rui-Hong Wu  1 , Xiu-Zhu Gao  1 , Hong-Qin Xu  1 , Yan-Hua Ding  2 , Jun-Qi Niu  3
Affiliations
Affiliations

    1
    Department of Hepatology, Key Laboratory of Zoonosis Research, Ministry Education, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China.
    2
    Phase I Clinical Trials Unit, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China.
    3
    Department of Hepatology, Key Laboratory of Zoonosis Research, Ministry Education, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China. [email protected].

    PMID: 34790015 PMCID: PMC8567480 DOI: 10.3748/wjg.v27.i40.6927

Abstract

Background: Quantitative hepatitis B core-related antigen (qHBcrAg) has a better correlation with intrahepatic hepatitis B virus (HBV) covalently closed circular DNA (cccDNA) than HBV DNA or hepatitis B e antigen (HBeAg), but data are still lacking for its clinical application.

Aim: The aim was to investigate serum qHBcrAg levels in patients with chronic hepatitis B and assess the correlation of serum qHBcrAg with pregenomic RNA (pgRNA), cccDNA, and HBeAg seroconversion.

Methods: This study was a secondary analysis of patients who underwent percutaneous liver biopsy between July 2014 and June 2019 in two multicenter randomized controlled clinical trials of peginterferon vs nucleos(t)ide analog (NUC)-based therapy (NCT03509688 and NCT03546530). Serum qHBcrAg, pgRNA, HBV DNA, hepatitis B core antigen, HBeAg, liver cccDNA, and HBV DNA were measured. The correlations of serum qHBcrAg with other biomarkers were analyzed.

Results: A total of 139 patients were included. The mean qHBcrAg levels were 5.32 ± 1.18 log10 U/mL at baseline and decreased during treatment (all P < 0.0001). Serum qHBcrAg levels were positively correlated with pgRNA (r = 0.597, P < 0.0001) and cccDNA (r = 0.527, P < 0.0001) levels. The correlation of serum qHBcrAg level and intrahepatic HBV DNA levels at baseline was weak but significant (r = 0.399, P < 0.0001). HBcrAg predicted HBeAg seroconversion, with areas under the receiver operating characteristics curve of 0.788 at 24 wk and 0.825 at 48 wk. Log HBcrAg at wk 24 and 48 was independently associated with HBeAg seroconversion [odds ratio (OR) = 2.402, 95% confidence interval (CI): 1.314-4.391, P = 0.004; OR = 3.587, 95%CI: 1.315-9.784, P = 0.013].

Conclusion: Serum HBcrAg levels were correlated with HBV virological markers and could be used to predict HBeAg seroconversion.

Keywords: Correlation; Detection; Hepatitis B core antigen; Hepatitis B virus; Hepatitis B virus DNA; Liver biopsy; Pregenomic RNA; Quantitative hepatitis B core-related antigen; Receiver operating characteristic; Seroconversion.

©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.

StephenW

https://www.wjgnet.com/1007-9327/full/v27/i40/6927.htm