HBsAg 阴性和 HBcAb 阳性成人的肝硬化/晚期纤维化

StephenW

HBsAg 阴性和 HBcAb 阳性成人的肝硬化/晚期纤维化

2022 年 10 月 13 日

HBsAg 阴性（乙肝表面抗原阴性）和 HBcAb 阳性（乙肝核心抗体阳性）患者在临床肝硬化评估时可能会漏诊。在这里，研究人员评估了 HBsAg 阴性但 HBcAb 阳性的美国成年人群中肝硬化/晚期纤维化的发生率。本分析中使用的 NHANES 数据跨越 2001 年至 2018 年。在这项研究中，研究人员招募了 3,115 名来自美国的成年人，他们的 HBcAb 检测呈阳性但 HBsAg 呈阴性。 Fibrosis-4 (FIB-4) 和天冬氨酸氨基转移酶与血小板比率指数 (APRI) 用于诊断肝硬化。大约 45,087 名 NHANES 个体接受了 HBcAb/HBsAg 检测；其中，3,115 人符合纳入标准（HBcAb 阴性/HBsAg 阳性与 FIB-4/APRI 的数据）。美国 HBsAg 阴性/HBcAb 阳性成人的患病率为 4.46%（95% CI 4.17-4.75），影响了 987 万人。 FIB-4 研究发现，在 HBsAg 阴性/HBcAb 阳性的美国成年人中，肝硬化/晚期纤维化的加权患病率为 3.76%（95% CI 2.80-4.72%），即 371,112（95% CI 276,360-465,864） ) 肝硬化患者。这个数字在 HBsAb 阴性（乙型肝炎表面抗体）个体中显着更高（6.28% 与非 APRI 结果相比，APRI 产生了相同的结果。约 3.76% 的 HBsAg 和 HBcAb 检测呈阳性的美国成年人患有肝硬化/晚期根据 FIB-4，肝纤维化的发病率远高于美国普通人群。根据他们的发现，在 HBsAg 阴性/HBcAb 阳性人群中筛查肝硬化对于预防严重肝病至关重要，尤其是对于HBsAb 阴性人群的子集。

来源：link.springer.com/article/10.1007/s40121-022-00680-2

StephenW

Cirrhosis/Advanced Fibrosis in HBsAg-Negative & HBcAb-Positive Adults

Oct 13, 2022

HBsAg-negative patients (hepatitis B surface antigen-negative) and HBcAb-positive (hepatitis B core antibody-positive) may be missed for cirrhosis evaluation in the clinic. Here, the researchers assess the rate of cirrhosis/advanced fibrosis in the United States’ adult population that tests negative for HBsAg but positive for HBcAb. The NHANES data used in this analysis spans the years 2001 through 2018. For this study, investigators enrolled 3,115 adults from the United States who tested positive for HBcAb but negative for HBsAg. Fibrosis-4 (FIB-4) and the aspartate aminotransferase to platelet ratio index (APRI) were used to diagnose cirrhosis. About 45,087 NHANES individuals were tested for HBcAb/HBsAg; of them, 3,115 matched the inclusion criteria (HBcAb-negative/HBsAg-positive with data for FIB-4/APRI). The prevalence of HBsAg-negative/HBcAb-positive adults in the United States was 4.46 percent (95% CI 4.17-4.75) and affected 9.87 million people. The FIB-4 study found that among HBsAg-negative/HBcAb-positive US adults, the weighted prevalence of cirrhosis/advanced fibrosis was 3.76% (95% CI 2.80-4.72%), which translates to 371,112 (95% CI 276,360-465,864) people with cirrhosis. This number was significantly higher among HBsAb-negative (hepatitis B surface antibody) individuals (6.28% When compared with non-APRI results, APRI produced equivalent outcomes. About 3.76% of US adults who tested positive for both HBsAg and HBcAb had cirrhosis/advanced fibrosis, a rate much greater than that of the general US population, according to the FIB-4. Based on their findings, screening for cirrhosis in the HBsAg-negative/HBcAb-positive population was critical to prevent severe liver disease, especially for the HBsAb-negative subset of the population.

Source: link.springer.com/article/10.1007/s40121-022-00680-2