Albumin-bilirubin score is associated with response to pegylated interferon and nucleos(t)ide analogues in chronic hepatitis B patients
Albumin-bilirubin score is associated with response to pegylated interferon and nucleos(t)ide analogues in chronic hepatitis B patients
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白蛋白-胆红素评分与慢性乙型肝炎患者对聚乙二醇干扰素和核苷（酸）类似物的反应相关
DOI：
10.1016/j.cca.2019.12.020
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发表时间：
2020
影响因子：
5
通讯作者：
Ou Qi-Shui
中科院分区：
文献类型：
--
作者：
Xun Zhen;Liu Can;Yu Qing-Qing;Lin Jin-Piao;Huang Jin-Lan;Yang Ting-Wen;Wu Wen-Nan;Wu Song-Hang;Ou Qi-Shui
背景和目的最近，白蛋白-胆红素 (ALBI) 评分在慢性乙型肝炎 (CHB) 中的作用尚未得到充分了解。我们的目的是探讨 ALBI 评分与慢性 HBV 感染自然史和 CHB 患者治疗反应的关系。方法评估了 849 名个体的 ALBI 评分，其中包括 721 名不同阶段未接受过抗 HBV 治疗的慢性 HBV 感染患者和 128 名健康对照。此外，还检测了243例乙型肝炎e抗原（HBeAg）阳性CHB患者接受聚乙二醇化干扰素α（PEG-IFN-α）或核苷（酸）类似物（NAs）治疗72周后ALBI评分的动态变化。结果各期ALBI评分存在差异，HBeAg阳性CHB患者评分最高，其次是 HBeAg 阴性慢性乙型肝炎患者、HBeAg 阳性慢性 HBV 感染者、HBeAg 阴性慢性 HBV 感染者。此外，基线 ALBI 评分较高的 CHB 患者对 PEG-IFN-α 或 NA 表现出相对较强的治疗反应。此外，在整个治疗过程中，ALBI 2 级患者的 HBeAg 和 HBsAg 消失率持续高于 ALBI 1 级患者。此外，ALBI 评分是持续缓解效果的独立预测因子。 ALBI评分与HBeAg和ALT的联合使用可以提高治疗反应的预测价值。结论在HBeAg阳性CHB患者中，ALBI评分在慢性HBV感染的自然病程中存在显着差异，并且与PEG-IFN-α和NAs治疗反应相关，这表明ALBI评分可作为辅助临床因素来确定治疗开始和预测更强的抗病毒治疗反应。
Background and aimRecently, the role of albumin-bilirubin (ALBI) score in chronic hepatitis B (CHB) has not been well-understood. We aimed to investigate the association of ALBI score with natural history of chronic HBV infection and treatment response of CHB patients.MethodsThe ALBI score in a cohort of 849 individuals including 721 chronic HBV-infected patients naïve to anti-HBV treatment in different phases and 128 healthy controls were estimated. Additionally, the dynamic changes of ALBI score of 243 hepatitis B e antigen (HBeAg)-positive CHB patients treated with pegylated interferon-alpha (PEG-IFN-α) or nucleos(t)ide analogues (NAs) were tested for 72 weeks.ResultsALBI score differed among phases, with the highest score in HBeAg-positive CHB patients, followed by HBeAg-negative CHB patients, HBeAg-positive chronic HBV infection, and HBeAg-negative chronic HBV infection. Besides, CHB patients harbouring high baseline ALBI score exhibited a relatively stronger therapeutic response to PEG-IFN-α or NAs. Moreover, the rate of HBeAg and HBsAg loss in patients with ALBI grade 2 was persistently higher than that in patients with ALBI grade 1 throughout the course of treatment. Furthermore, ALBI score was an independent predictor of sustained response achievement. The combined use of ALBI score, HBeAg and ALT could enhance the predictive value of treatment response.ConclusionsALBI score differed significantly across the natural course of chronic HBV infection and was correlated with PEG-IFN-α and NAs treatment response in HBeAg-positive CHB patients, which suggested that ALBI score could be useful as an auxiliary clinical factor to determine the initiation of therapy and predict stronger antiviral treatment response.