定量 HBsAg 与 HBV DNA 在预测 HBeAg 阳性慢性 HBV 感染的显着肝炎

StephenW

定量 HBsAg 与 HBV DNA 在预测 HBeAg 阳性慢性 HBV 感染的显着肝炎活动中
张展清1、卫路1、董增2、丹黄1、魏家林1、李艳1、严玲凤2
隶属关系
隶属关系

    1
    复旦大学上海市公共卫生临床中心肝胆内科，上海201508
    2
    复旦大学上海市公共卫生临床中心临床病理科，上海201508

    PMID：34884319 DOI：10.3390/jcm10235617

抽象的

(1)背景：作为预测乙型肝炎e抗原（HBeAg）阳性慢性乙型肝炎病毒（HBV）感染显着肝炎活动的特殊参数，HBV DNA的定量标准尚未达成一致，乙型肝炎表面抗原（HBsAg）的定量标准尚未达成一致。 ) 尚未形成。我们的目标是评估 HBsAg 和 HBV DNA 在预测 HBeAg 阳性患者的显着肝炎活动性方面的有效性。 (2)方法：纳入516例HBeAg阳性慢性HBV感染患者。使用 Abbott Architect c16000 自动分析仪测量血清 ALT；肝脏病理分级和分期的诊断参照 Scheuer 标准。预设了三个显着肝炎活动水平，依次为“ALT ≥ 20 IU/L or Grade > G1 or Stage > S1”、“ALT ≥ 30 IU/L or Grade > G1 or Stage > S1”和“ALT ≥ 40” IU/L 或等级 > G1 或阶段 > S1"。 (3)结果：根据ALT与HBsAg、HBeAg与HBV DNA的局部加权散点图平滑回归曲线，筛选出288例可能存在HBV高复制的患者亚群。在可能存在HBV高复制的亚群中，HBsAg用于预测三个显着肝炎活动水平的受试者工作特征曲线下面积依次为0.868、0.839和0.789，均显着大于HBV DNA，分别为0.553 , 0.550 和 0.574（p = 0.0002，p < 0.0001 和 p < 0.0001）。在HBsAg≤4.699 log10 IU/mL的标准下，HBsAg预测三个显着肝炎活动水平的敏感性和特异性依次为75.81%和81.82%、79.23%和78.57%和80.82%和67.44%。 (4)结论：定量HBsAg代替HBV DNA对预测HBeAg阳性慢性HBV感染者的肝炎活动性具有重要意义。

关键词：慢性乙型肝炎病毒感染；乙型肝炎表面抗原；乙型肝炎病毒DNA；自然历史;显着的肝炎活动。
拨款支持

    2017ZX10203202/中华人民共和国科学技术部
    SHDC12016237/上海申康医院发展中心

StephenW

Quantitative HBsAg versus HBV DNA in Predicting Significant Hepatitis Activity of HBeAg-Positive Chronic HBV Infection
Zhanqing Zhang  1 , Wei Lu  1 , Dong Zeng  2 , Dan Huang  1 , Weijia Lin  1 , Li Yan  1 , Yanling Feng  2
Affiliations
Affiliations

    1
    Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center of Fudan University, Shanghai 201508, China.
    2
    Department of Clinical Pathology, Shanghai Public Health Clinical Center of Fudan University, Shanghai 201508, China.

    PMID: 34884319 DOI: 10.3390/jcm10235617

Abstract

(1) Background: As specialparameters in predicting significant hepatitis activity of hepatitis B e antigen (HBeAg)-positive chronic hepatitis B virus (HBV) infection, the quantitative standard of HBV DNA has not been agreed and that of hepatitis B surface antigen(HBsAg) has not been formed. Our objective is to evaluate the validity of HBsAg and HBV DNA in predicting the significant hepatitis activity of HBeAg-positive patients. (2) Methods: A population of 516 patients with HBeAg-positive chronic HBV infection was enrolled. Serum ALT was measured using an Abbott Architect c16000 autoanalyzer; diagnoses of liver pathological grade and stage referred to the Scheuer standard. Three levels of significant hepatitis activity were preset, which were successively "ALT ≥ 20 IU/L or Grade > G1 or Stage > S1", "ALT ≥ 30 IU/L or Grade > G1 or Stage > S1" and "ALT ≥ 40 IU/L or Grade > G1 or Stage > S1". (3) Results: A subpopulation of 288 patients with possible high HBV replication was selected based on locally weighted scatterplot smoothing regression curves between ALT and HBsAg, HBeAg and HBV DNA. In the subpopulation with possible high HBV replication, areas under receiver operating characteristic curves of HBsAg for predicting the three levels of significant hepatitis activity were successively 0.868, 0.839 and 0.789, which were all significantly greater than those of HBV DNA, as those were successively 0.553, 0.550 and 0.574 (p = 0.0002, p < 0.0001 and p < 0.0001). With the standard of HBsAg ≤ 4.699 log10 IU/mL, the sensitivity and specificity of HBsAg for predicting the three levels of significant hepatitis activity were successively 75.81% and 81.82%, 79.23% and 78.57% and 80.82% and 67.44%. (4) Conclusion: Quantitative HBsAg instead of HBV DNA is valuable in predicting significant hepatitis activity of HBeAg-positive chronic HBV infection.

Keywords: chronic hepatitis B virus infection; hepatitis B surface antigen; hepatitis B virus DNA; natural history; significant hepatitis activity.
Grant support

    2017ZX10203202/Ministry of Science and Technology of the People's Republic of China
    SHDC12016237/Shanghai Shenkang Hospital Development Center

StephenW

https://www.mdpi.com/2077-0383/10/23/5617/pdf