Department of Research and Molecular Development, Victorian Infectious Diseases Reference Laboratory, North Melbourne, Vic., Australia.
J Hepatol. 2010 Apr;52(4):508-13. doi: 10.1016/j.jhep.2010.01.007. Epub 2010 Feb 16.
BACKGROUND & 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.
Two-hundred and twenty patients were classified into immune-tolerant (IT), immune-clearance (IC), non/low-replicative (LR) or hepatitis B e 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.
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.
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.
临床试验数据表明，在聚乙二醇干扰素-α（pegIFN）治疗期间监测血清 HBsAg 滴度可能有助于预测病毒学应答。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描述。我们旨在确定感染乙型肝炎病毒（HBV）基因型 B 或 C 的亚洲患者队列中 CHB 不同阶段的血清 HBsAg 滴度。
将 220 例患者分为免疫耐受（IT）、免疫清除（IC）、非/低复制（LR）或乙型肝炎 e 抗原阴性肝炎（ENH）期。使用 ARCHITECT 平台（美国雅培实验室）定量检测血清 HBsAg。在每个感染阶段，对 HBsAg 滴度与 HBV DNA 和血清 ALT 进行相关性分析。
CHB 各阶段的 HBsAg 滴度中位数不同（p=0.001）：IT（4.53 log10IU/ml）、IC（4.03 log10IU/ml）、LR（2.86 log10IU/ml）和 ENH（3.35 log10IU/ml）。IT 期 HBsAg 滴度最高，LR 期最低。总体而言，基因型 B 和 C 的 HBV 血清 HBsAg 滴度中位数相似。血清 HBsAg 滴度仅与 IC 期的 HBV 病毒载量相关。未观察到血清 HBsAg 水平与 ALT 之间的相关性。
本研究表明，CHB 不同阶段的中位基线血清 HBsAg 滴度存在显著差异。这些结果为 CHB 不同阶段 HBV 病毒生命周期提供了进一步的深入了解。基线 HBsAg 定量可能有助于为免疫调节剂治疗和口服核苷（酸）类似物治疗制定更精细的治疗方案。
