Serum hepatitis B surface antigen levels in the natural history of chronic hepatitis B infection
Serum hepatitis B surface antigen levels in the natural history of chronic hepatitis B infection
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DOI：
10.1111/j.1365-2036.2011.04888.x
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发表时间：
2011-12-01
影响因子：
7.6
通讯作者：
Chung, K. W.
中科院分区：
文献类型：
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作者：
Jang, J. W.;Yoo, S. H.;Chung, K. W.
背景在慢性B型肝炎（CH B）的长期病毒-宿主相互作用过程中，可能会产生B型肝炎表面抗原（HBsAg）。年龄对HBsAg产生的影响尚不清楚。目的探讨慢性乙型肝炎（CHB）自然感染过程中HBsAg的年龄分布规律及其相关因素。方法对768例未经治疗的HBsAg携带者进行研究。HBsAg的参数和分布模式进行了评价与年龄和免疫阶段。结果HBeAg阴性期HBsAg水平明显降低，以非活动期HBsAg水平最低。从肝炎到肝硬化再到肝癌，从ChildPugh A级到B级再到C级，HBsAg有降低的趋势。年龄和HBV DNA与HBsAg水平独立相关。在HBeAg阳性患者中，HBsAg水平在各年龄层中以2个对数的三相样下降模式分布。对于HBeAg阴性患者，非活动性携带者的滴度显示出2个对数的降低，但在HBeAg阴性肝炎患者的年龄层中保持不变。HBsAg/HBV-DNA比值最高，但在非活动性携带者中随着年龄的增长而稳步下降，而在HBeAg阴性肝炎患者中，整个年龄层的HBsAg/HBV-DNA水平基本保持不变。结论年龄和HBV DNA水平是影响HBsAg水平的独立因素。在CHB感染的自然过程中，HBsAg水平随着年龄和疾病进展而降低，但CHB免疫阶段之间的模式有显着差异。这一信息可能有助于我们了解慢性B型肝炎的免疫发病机制和管理涉及HBsAg定量。
Background The production of hepatitis B surface antigen (HBsAg) may evolve during long-lasting virus-host interactions in chronic hepatitis B (CHB). The impact of age on HBsAg production remains unclear. Aim To determine the age-specific distribution patterns of HBsAg and related factors during the natural course of CHB infection. Methods Seven hundred and sixty-eight untreated HBsAg carriers were enrolled in the study. The parameters and distribution patterns of HBsAg were evaluated in relation to age and immune phases. Results The HBsAg levels were significantly lower in the HBeAg-negative stage, with the lowest levels in inactive carriers. The HBsAg tended to decrease from hepatitis to cirrhosis and to hepatocellular carcinoma, and from ChildPugh class A to B and to C. Age and HBV DNA were independently associated with HBsAg levels. In HBeAg-positive patients, the HBsAg levels were distributed in a triphasic-like decline pattern by 2 logs across age strata. For HBeAg-negative patients, the titres in inactive carriers exhibited a 2-log reduction, but remained unchanged over age strata in patients with HBeAg-negative hepatitis. The ratios of HBsAg/HBV-DNA were highest, but steadily decreased with age in inactive carriers, whereas the levels remained largely unchanged over the entire age strata in patients with HBeAg-negative hepatitis. Conclusions Age and HBV DNA levels are independent parameters of HBsAg levels. During the natural course of CHB infection, HBsAg levels decrease with age and disease progression, but the patterns are significantly different between the immune phases of CHB. This information may contribute to our understanding of the immunopathogenesis of chronic hepatitis B and management involving HBsAg quantification.