Su Tung-Hung, Hsu Ching-Sheng, Chen Chi-Ling, Liu Chen-Hua, Huang Yi-Wen, Tseng Tai-Chung, Liu Chun-Jen, Chen Pei-Jer, Lai Ming-Yang, Chen Ding-Shinn, Kao Jia-Horng
Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
Antivir Ther. 2010;15(8):1133-9. doi: 10.3851/IMP1696.
Serum HBV DNA level is crucial in the management of chronic hepatitis B (CHB); however, the assay is expensive and cannot be used widely. Therefore, we explored the possibility of hepatitis B surface antigen (HBsAg) quantification as a surrogate marker for HBV DNA level in CHB patients.
A total of 289 CHB patients were enrolled, 251 were evaluated at baseline and 75 of them were also evaluated during anti-HBV treatment. Another 38 on-treatment patients were used for validation. Serum HBsAg titre was quantified by an immunoassay and HBV DNA level by a PCR-based method. Baseline and on-treatment data were analysed.
In parallel to log(10) HBV DNA, the log(10) HBsAg was high in both immune tolerance and immune clearance phases, and significantly decreased in the inactive carrier state and was again increased in the reactivation phase of the CHB infection. There was a positive correlation between log(10) HBsAg and log(10) HBV DNA, which was greater in patients with chronic hepatitis, hepatitis B e antigen-positivity, greater alanine aminotransferase or HBsAg levels at baseline and during pegylated interferon treatment. Log(10) HBsAg could predict log(10) HBV DNA independently. An HBsAg titre of >900 IU/ml at baseline or >1,500 IU/ml within the first year of treatment could predict an HBV DNA level of >20,000 IU/ml, especially in subgroups of chronic hepatitis with alanine aminotransferase levels >40 IU/l. The dynamics of HBsAg might also predict serial HBV DNA changes. In the validation group, 64% of patients with on-treatment HBV DNA levels >20,000 IU/ml could be correctly predicted.
Serum HBsAg concentration might serve as a surrogate marker of HBV DNA level in CHB patients.
血清乙肝病毒脱氧核糖核酸（HBV DNA）水平在慢性乙型肝炎（CHB）的管理中至关重要；然而，该检测成本高昂且无法广泛应用。因此，我们探讨了将乙肝表面抗原（HBsAg）定量作为CHB患者HBV DNA水平替代标志物的可能性。
共纳入289例CHB患者，251例在基线时进行评估，其中75例在抗HBV治疗期间也进行了评估。另外38例正在接受治疗的患者用于验证。通过免疫测定法定量血清HBsAg滴度，通过基于聚合酶链反应（PCR）的方法测定HBV DNA水平。对基线和治疗期间的数据进行分析。
与log(10) HBV DNA平行，log(10) HBsAg在免疫耐受期和免疫清除期均较高，在非活动性携带者状态下显著降低，在CHB感染的再激活期再次升高。log(10) HBsAg与log(10) HBV DNA之间存在正相关，在慢性肝炎、乙肝e抗原阳性、基线及聚乙二醇干扰素治疗期间丙氨酸氨基转移酶或HBsAg水平较高的患者中相关性更强。Log(10) HBsAg可独立预测log(10) HBV DNA。基线时HBsAg滴度>900 IU/ml或治疗第一年期间>1500 IU/ml可预测HBV DNA水平>20000 IU/ml，尤其是在丙氨酸氨基转移酶水平>40 IU/l的慢性肝炎亚组中。HBsAg的动态变化也可能预测连续的HBV DNA变化。在验证组中，64%治疗期间HBV DNA水平>20000 IU/ml的患者可被正确预测。
血清HBsAg浓度可能作为CHB患者HBV DNA水平的替代标志物。
