结合 HBcrAg 下降和 HBV 突变预测慢性乙型肝炎患者在免疫清除

StephenW

结合 HBcrAg 下降和 HBV 突变预测慢性乙型肝炎患者在免疫清除阶段的自发 HBeAg 血清学转换
谢炎帝 1 , 马辉 1 , 波峰 1 , 宋广军 1
隶属关系
联系

    1
    北京大学人民医院，北京大学肝病研究所，丙型肝炎与肝病免疫治疗北京市重点实验室，北京非酒精性脂肪肝诊断国际科技合作基地，北京，中国。

    PMID：34951036 DOI：10.1002/jmv.27545

抽象的

目的：评估乙型肝炎病毒（HBV）标志物和基因组突变对自发性乙型肝炎e抗原（HBeAg）血清学转换的预测能力。

方法：对113例慢性乙型肝炎（CHB）患者进行76周的随访，未进行抗病毒治疗。检测基线基础核心启动子（BCP）和前核心突变，并连续定量血清乙型肝炎表面抗原（HBsAg）、HBeAg、乙型肝炎核心相关抗原（HBcrAg）和HBV DNA水平。

结果：18 名患者出现自发的 HBeAg 血清学转换（A 组），其余 95 名患者未出现自发的 HBeAg 血清学转换（B 组）。在第 28 周，A 组和 B 组之间的 HBsAg（P=0.03）和 HBcrAg（P=0.01）水平有显着差异。从基线到第 28 周，HBsAg（P=0.02）和 HBcrAg（P<0.01）水平的降低有显着差异两组之间。多变量逻辑回归显示，第 28 周较低的 HBcrAg（OR=1.02，P=0.03）水平和第 28 周急剧下降的 HBcrAg 水平（OR=0.19，P=0.02）与自发性 HBeAg 血清学转换有关。接受者操作特征曲线下面积 (AUROC) 显示 HBcrAg 水平从基线到第 28 周的降低（0.93，P=0.001，95% CI：0.74-1.08）具有极好的预测价值。 A1574T (51.11% vs 18.18%, P=0.001)、G1862A (30.00% vs 13.03%, P=0.001)、G1896A (27.22% vs 5.45%, P=0.0901.23%, P=0.0901.233%)的突变频率, P=0.001) A 组显着高于 B 组。

结论：基线 A1574T、G1862A、G1896A 和 C1913G 突变和 HBcrAg 水平在第 28 周急剧下降与自发性 HBeAg 血清学转换相关。本文受版权保护。版权所有。

关键词：乙肝核心相关抗原；乙型肝炎病毒;突变;自发性乙型肝炎 e 抗原血清学转换。

本文受版权保护。版权所有。

StephenW

Combining the HBcrAg decline and HBV mutations predicts spontaneous HBeAg seroconversion in chronic hepatitis B patients during the immune clearance phase
Yandi Xie  1 , Hui Ma  1 , Bo Feng  1 , Guangjun Song  1
Affiliations
Affiliation

    1
    Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis, Beijing, China.

    PMID: 34951036 DOI: 10.1002/jmv.27545

Abstract

Objective: To assess predictive ability of hepatitis B virus (HBV) markers and genome mutations for spontaneous hepatitis B e antigen (HBeAg) seroconversion.

Methods: A total of 113 chronic hepatitis B (CHB) patients were followed up for 76 weeks without antiviral treatment. Baseline basal core promoter (BCP) and precore mutations were detected and serum hepatitis B surface antigen (HBsAg), HBeAg, hepatitis B core-related antigen (HBcrAg) and HBV DNA levels were serially quantified.

Results: Eighteen patients experienced spontaneous HBeAg seroconversion (Group A), and the left 95 patients did not experience spontaneous HBeAg seroconversion (Group B). At week 28, HBsAg (P=0.03) and HBcrAg (P=0.01) levels were significantly different between Group A and B. Reduced HBsAg (P=0.02) and HBcrAg (P<0.01) levels from baseline to week 28 were significantly different between two groups. Multivariate logistic regression showed that lower HBcrAg (OR=1.02, P=0.03) levels at week 28, and HBcrAg levels with sharp decrease at week 28 (OR=0.19, P=0.02) were related with spontaneous HBeAg seroconversion. The areas under the receiver operating characteristic curve (AUROC) showed that reduction in HBcrAg levels from baseline to week 28 (0.93, P=0.001, 95% CI: 0.74-1.08) have excellent prediction value. The mutation frequencies of A1574T (51.11% vs 18.18%, P=0.001), G1862A (30.00% vs 13.03%, P=0.001), G1896A (27.22% vs 5.45%, P=0.001) and C1913G (32.78% vs 12.73%, P=0.001) in Group A were significantly higher than Group B.

Conclusions: Baseline A1574T, G1862A, G1896A and C1913G mutations and HBcrAg levels with sharp decrease at week 28 were associated with spontaneous HBeAg seroconversion. This article is protected by copyright. All rights reserved.

Keywords: hepatitis B core-related antigen; hepatitis B virus; mutation; spontaneous hepatitis B e antigen seroconversion.

This article is protected by copyright. All rights reserved.