Relationship between hepatitis B core-related antigen levels and sustained HBeAg seroconversion in patients treated with nucleo(s)tide analogues
Relationship between hepatitis B core-related antigen levels and sustained HBeAg seroconversion in patients treated with nucleo(s)tide analogues
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DOI：
10.1111/jvh.13097
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发表时间：
2019-07-01
影响因子：
2.5
通讯作者：
van der Eijk, Annemiek A.
中科院分区：
文献类型：
--
作者：
Sonneveld, Milan J.;van Oord, Gertine W.;van der Eijk, Annemiek A.
在核苷类似物（NUC）治疗期间经历的B e抗原（HBeAg）血清转换通常不持续。我们的目的是研究B型肝炎核心相关抗原（HBcrAg）水平是否能预测NUC治疗患者持续的HBeAg血清转换。我们研究了HBeAg阳性患者接受NUC治疗至少6个月。我们在基线和HBeAg血清转换时定量HBcrAg，并研究与HBeAg血清转换和随后复发的关系。196例患者在基线时定量HBcrAg;水平因HBV基因型而显著不同，并与HBsAg、HBV DNA和HBeAg相关。HBeAg血清转换患者的基线HBcrAg水平低于未转换患者;未校正的风险比（HR）为0.802（95%CI：0.656-0.980，P = 0.031）;多变量分析中，这种关联并不持久。在HBeAg血清转换时，HBcrAg在所有患者中仍可检测到。血清转换时较高的HBcrAg是复发的独立预测因子（校正HR：1.855（95%CI：1.099-3.133，P = 0.021），HBcrAg mL患者均未复发。基线HBcrAg不是NUC治疗期间HBeAg血清转换的独立预测因素。在HBeAg血清转换后，HBcrAg仍可检测到。血清转换时HBeAg水平较低的患者有较高的持续HBeAg血清转换的可能性。
Hepatitis B e antigen (HBeAg) seroconversion experienced during nucleo(s)tide analogue (NUC) therapy is often not sustained. We aimed to study whether hepatitis B core-related antigen (HBcrAg) levels predict sustained HBeAg seroconversion in patients treated with NUCs. We studied HBeAg-positive patients treated with NUCs for at least 6 months. We quantified HBcrAg at baseline and at the time of HBeAg seroconversion and studied the relationship with HBeAg seroconversion and subsequent relapse. HBcrAg was quantified at baseline in 196 patients; levels varied significantly by HBV genotype and correlated with HBsAg, HBV DNA and HBeAg. Baseline HBcrAg levels were lower in patients who achieved HBeAg seroconversion than in those who did not; the unadjusted hazard ratio (HR) was 0.802 (95% CI: 0.656-0.980, P = 0.031); and this association was not sustained in multivariate analysis. HBcrAg remained detectable in all patients at the time of HBeAg seroconversion. Higher HBcrAg at the time of seroconversion was an independent predictor of relapse (adjusted HR: 1.855 (95% CI: 1.099-3.133, P = 0.021), and none of the patients with HBcrAg mL experienced relapse. Baseline HBcrAg is not an independent predictor of HBeAg seroconversion during NUC therapy. HBcrAg remains detectable in patients after HBeAg seroconversion. Patients with lower levels at the time of seroconversion have a higher probability of sustained HBeAg seroconversion.