Hepatitis B surface antigen levels during the natural history of chronic hepatitis B: A perspective on Asia
Hepatitis B surface antigen levels during the natural history of chronic hepatitis B: A perspective on Asia
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DOI：
10.1016/j.jhep.2010.01.007
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发表时间：
2010-04-01
影响因子：
25.7
通讯作者：
Locarnini, Stephen A.
中科院分区：
文献类型：
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作者：
Nguyen, Tin;Thompson, Alexander J. V.;Locarnini, Stephen A.
背景：目的：临床试验数据表明，在干扰素- α (pegIFN)治疗期间监测血清HBsAg滴度在预测病毒学反应方面具有潜在作用。然而，慢性乙型肝炎（CHB）自然史期间的基线HBsAg滴度尚未得到很好的表征。我们的目的是确定基因型B或C型HBV感染的亚洲患者在CHB不同阶段的血清HBsAg滴度。方法：将220例患者分为免疫耐受期（IT）、免疫清除期（IC）、非/低复制期（LR）和乙型肝炎抗原阴性期（ENH）。采用ARCHITECT平台（Abbott Laboratories, Chicago， USA）对血清HBsAg进行量化。检测感染各阶段HBsAg滴度与HBV DNA和血清ALT的相关性。结果：CHB各期中位HBsAg滴度不同（p = 0.001）： IT期（4.53 log(10) IU/ml）， IC期（4.03 log(10) IU/ml）， LR期（2.86 log(10) IU/ml）， ENH期（3.35 log(10) IU/ml）。HBsAg滴度在IT期最高，LR期最低。总体而言，基因型B和基因型C之间的中位HBsAg滴度相似。在IC期，血清HBsAg滴度仅与HBV病毒载量相关。血清HBsAg水平与ALT无相关性。结论：该研究表明，不同期CHB的中位基线血清HBsAg滴度存在显著差异。这些结果提供了进一步了解HBV病毒生命周期在CHB的不同阶段的设置。基线HBsAg定量可能有助于改进免疫调节剂治疗和口服核苷类似物治疗的未来治疗算法。2010年欧洲肝脏研究协会。Elsevier B.V.版权所有。
Background Re Aims: Data from clinical trials suggest a potential role for on-treatment monitoring of serum HBsAg titres during interferon-alpha (pegIFN) therapy in predicting virological responses. However, baseline HBsAg titres during the natural history of chronic hepatitis B (CHB) have not been well-characterized. We aimed to define the serum HBsAg titres during the different phases of CHB in a cohort of Asian patients infected with either genotype B or C HBV.Methods: Two-hundred and twenty patients were classified into immune-tolerant (IT), immune-clearance (IC), non/low-replicative (LR) or hepatitis Be antigen negative hepatitis (ENH) phases. Serum HBsAg was quantified using the ARCHITECT platform (Abbott Laboratories, Chicago, USA). Correlation of HBsAg titre with HBV DNA and serum ALT within each phase of infection was performed.Results: Median HBsAg titres were different between each phase of CHB (p = 0.001): IT (4.53 log(10) IU/ml), IC (4.03 log(10) IU/ml), LR (2.86 log(10) IU/ml), and ENH (3.35 log(10) IU/ml). HBsAg titres were highest in the IT phase, and lowest in the LR phase. In general, median HBsAg titres were similar between genotypes B and C HBV. Serum HBsAg titres only correlated with HBV viral load in the IC phase. No correlation between the serum HBsAg level and ALT was observed.Conclusions: This study demonstrated significant differences in median baseline serum HBsAg titres across the different phases of CHB. These results provide further insight into the HBV viral life cycle in the setting of the various phases of CHB. Baseline HBsAg quantification may help refine future treatment algorithms for both immune-modulator therapy and oral nucleos(t)ide analogue therapy. (c) 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.