血清可溶性程序性死亡 1 水平可预测慢性乙型肝炎的自发 HBeA

StephenW

血清可溶性程序性死亡 1 水平可预测慢性乙型肝炎的自发 HBeAg 血清清除

    Yu-Ju Chu, Wen-Juei Jeng, Mei-Hung Pan, Hui-Han Hu, Wen-Sheng Luo, Chien-Yu Su, Chen-Tse Chiang, Chin-Lan Jen, Chien-Jen Chen & Hwai-I Yang

胃肠病学杂志第 57 卷，第 423–432 页（2022 年）引用这篇文章

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抽象的
背景和目标

在慢性乙型肝炎病毒 (HBV) 感染中，乙型肝炎 e 抗原 (HBeAg) 的早期血清清除与更有利的结果相关。可溶性程序性细胞死亡 1 (sPD-1) 与较高的病毒载量和肝细胞癌有关。我们调查了 sPD-1 水平与自发 HBeAg 血清学清除之间的关联。
方法

对 REVEAL-HBV 队列中 488 名 HBeAg 血清阳性患者的基线血清样本进行了 sPD-1 水平检测。其中，329份有可用的后续血清样本进行了进一步检测。多变量 Cox 回归分析用于估计调整后的比率 (aRR) 和 95% 置信区间 (CI)，并调整宿主和病毒因素。第 66 个百分位和每年减少 ≥ 10% 分别用作基线 sPD-1 水平（高/低）和 sPD-1 轨迹（下降/不下降）的分界点。
结果

较低的基线 sPD-1 水平 [aRR (95% CI): 2.19 (1.47–3.27)] 和 sPD-1 水平的长期下降 [aRR (95% CI): 4.08 (2.79–5.97)] 都是独立的预测因子用于 HBeAg 血清学清除。然而，HBV 基因型的进一步分层分析表明，较低的基线 sPD-1 水平仅在基因 C 型感染中与 HBeAg 血清清除显着相关 [aRR (95% CI): 4.47 (2.38–8.37)]，但在基因型 B 感染中不显着。另一方面，无论 HBV 基因型如何，sPD-1 水平的长期下降都预示着 HBeAg 血清学清除，对于基因型 B，aRR (95% CI) 分别为 4.62 (2.71-7.88) 和 2.95 (1.68-5.17)和 C。
结论

血清 sPD-1 水平可作为慢性乙型肝炎患者自发 HBeAg 血清学清除的新免疫学预测指标。

StephenW

Serum soluble programmed death-1 levels predict the spontaneous HBeAg seroclearance in chronic hepatitis B

    Yu-Ju Chu, Wen-Juei Jeng, Mei-Hung Pan, Hui-Han Hu, Wen-Sheng Luo, Chien-Yu Su, Chen-Tse Chiang, Chin-Lan Jen, Chien-Jen Chen & Hwai-I Yang

Journal of Gastroenterology volume 57, pages 423–432 (2022)Cite this article

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Abstract
Background and aims

In chronic hepatitis B virus (HBV) infection, earlier seroclearance of hepatitis B e antigen (HBeAg) is associated with more favorable outcomes. Soluble programmed cell death 1 (sPD-1) has been implicated in higher viral load and hepatocellular carcinoma. We investigated the association between sPD-1 levels and spontaneous HBeAg seroclearance.
Methods

Baseline serum samples from 488 HBeAg-seropositive patients in the REVEAL-HBV cohort were tested for sPD-1 levels. Among them, 329 with available follow-up serum samples were further assayed. Multivariate Cox regression analysis was used to estimate the adjusted rate ratio (aRR) and 95% confidence interval (CI) with adjustment of host and viral factors. The 66th percentile and an annual reduction of ≥ 10% were used as the cut-off point for baseline sPD-1 levels (high/low) and sPD-1 trajectory (decline/no decline), respectively.
Results

Lower baseline sPD-1 levels [aRR (95% CI): 2.19 (1.47–3.27)] and long-term decline in sPD-1 levels [aRR (95% CI): 4.08 (2.79–5.97)] were both independent predictors for HBeAg seroclearance. However, further stratification analysis by HBV genotype showed that lower baseline sPD-1 levels were significantly associated with HBeAg seroclearance only in genotype C infection [aRR (95% CI): 4.47 (2.38–8.37)] but not in genotype B infection. On the other hand, long-term decline in sPD-1 levels was predictive for HBeAg seroclearance regardless of HBV genotype with aRR (95% CI) of 4.62 (2.71–7.88) and 2.95 (1.68–5.17), respectively, for genotypes B and C.
Conclusion

Serum sPD-1 levels may serve as a novel immunological predictor for spontaneous HBeAg seroclearance in patients with chronic hepatitis B.