Predictive effect of serial serum alanine aminotransferase levels on spontaneous HBeAg seroconversion in chronic genotype B and C HBV-infected children.
Predictive effect of serial serum alanine aminotransferase levels on spontaneous HBeAg seroconversion in chronic genotype B and C HBV-infected children.
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DOI：
10.1097/mpg.0b013e31822a033e
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发表时间：
2012-01
影响因子：
2.9
通讯作者：
Chang MH
中科院分区：
文献类型：
--
作者：
Wu JF;Su YR;Chen CH;Chen HL;Ni YH;Hsu HY;Wang JL;Chang MH
本研究旨在探讨慢性B病毒（HBV）感染儿童血清丙氨酸氨基转移酶（ALT）与自发性B e抗原（HBeAg）血清转换年龄的关系。104例HBeAg阳性慢性基因型B或C HBV感染患者被纳入这项长期前瞻性队列研究（平均初始年龄7.20岁）。每6 ~ 12个月检测一次血清ALT水平和HBV血清学标志物。104例受试者在研究期间共进行了2525次访视，大多数（93.6%）访视与既往访视间隔在1年内。采用考克斯比例风险模型对这些受试者的HBeAg生存率进行分析。在HBV感染的慢性病程中，ALT水平超过20、30、40、60和150 IU/L后，至自发HBeAg血清转换的中位剩余时间分别为8.35、5.14、4.25、3.95和2.80年。ALT在60 ~ 150 IU/L时6个月内HBeAg自发血清转换发生率是ALT <60 IU/L时的5.57倍。ALT> 150 IU/L时HBeAg血清转换发生率是ALT <60 IU/L时的9.87倍。ALT水平高于30 IU/L可作为慢性基因型B和C HBV感染患者炎症期的临界值。慢性HBV感染受试者的系列ALT水平可预测自发性HBeAg血清转换的发生。
The present study aimed to investigate the association between serial serum alanine aminotransferase (ALT) and spontaneous hepatitis B e antigen (HBeAg) seroconversion age in chronic hepatitis B virus (HBV)–infected children. One hundred four HBeAg-positive chronic genotype B or C HBV–infected patients were included in this long-term prospective cohort study (mean initial age 7.20 years). Serial serum ALT levels and HBV serology markers were measured every 6 to 12 months. The 104 subjects made a total of 2525 visits during the study period, and the majority (93.6%) of visits were within a 1-year interval apart from previous visits. Cox proportional hazards model with time-dependent covariates was used in the survival analysis of HBeAg in these subjects. During the chronic course of HBV infection, the median remaining times to spontaneous HBeAg seroconversion were 8.35, 5.14, 4.25, 3.95, and 2.80 years after the ALT levels crossed 20, 30, 40, 60, and 150 IU/L, respectively. The incidence rate of spontaneous HBeAg seroconversion within 6 months when a subject entered the phase of ALT between 60 and 150 IU/L was 5.57 times that of the phase with ALT <60 IU/L. The incidence rate of HBeAg seroconversion once ALT levels were above 150 IU/L was 9.87 times that of the phase of ALT <60 IU/L. The ALT levels above 30 IU/L served as a cutoff of the inflammatory phase in chronic genotype B and C HBV–infected patients. Serial ALT levels in chronic HBV–infected subjects offer a predicted effect on the occurrence of spontaneous HBeAg seroconversion.