Department of Medicine and Therapeutics and Institute of Digestive Disease, The Chinese University of Hong Kong.
J Infect Dis. 2011 Aug 1;204(3):408-14. doi: 10.1093/infdis/jir283.
We studied whether quantification of serum HBsAg and HBV DNA levels could predict spontaneous HBsAg clearance in patients with negative hepatitis B e antigen (HBeAg).
Serum HBsAg and HBV DNA levels were measured at baseline among a longitudinal cohort of 103 HBeAg-negative patients recruited since 1997.
Twelve (12%) patients developed HBsAg seroclearance after 88 ± 26 months (range, 21-139) of follow-up. At baseline, the serum HBsAg level among patients who cleared HBsAg (1.30 ± 1.27 log IU/mL) was significantly lower than those who did not clear HBsAg (2.96 ± 0.84 log IU/mL; P < .001). The area under receiver operating characteristics (ROC) curve for serum HBsAg to predict HBsAg seroclearance was 0.90 (95% confidence interval [CI], 0.83-0.97; P < .001). Nine (75%) of 12 patients who had HBsAg seroclearance versus 8 (9%) of 91 who remained HBsAg-positive had serum HBsAg ≤100 IU/mL at the baseline (P < .001). An HBsAg cutoff of ≤100 IU/mL had 75% sensitivity and 91% specificity to predict HBsAg seroclearance. Baseline serum HBV DNA could not predict HBsAg seroclearance; the area under ROC curve was 0.64 (95% CI, 0.46-0.81; P = .13).
Single-point serum HBsAg level can predict the chance of HBsAg seroclearance in chronic hepatitis B patients with negative HBeAg.
我们研究了血清 HBsAg 和 HBV DNA 水平的定量检测是否可以预测乙型肝炎 e 抗原（HBeAg）阴性患者的自发性 HBsAg 清除。
对 1997 年以来招募的 103 名 HBeAg 阴性的纵向队列患者进行了基线血清 HBsAg 和 HBV DNA 水平的检测。
12 名（12%）患者在 88±26 个月（范围 21-139）的随访后发生 HBsAg 血清学清除。在基线时，HBsAg 清除患者的血清 HBsAg 水平（1.30±1.27 log IU/mL）明显低于未清除 HBsAg 的患者（2.96±0.84 log IU/mL；P＜0.001）。血清 HBsAg 预测 HBsAg 血清学清除的受试者工作特征（ROC）曲线下面积为 0.90（95%置信区间 [CI]，0.83-0.97；P＜0.001）。与 91 例 HBsAg 持续阳性的患者相比，12 例 HBsAg 清除的患者中有 9 例（75%）基线时的血清 HBsAg 水平≤100 IU/mL（P＜0.001）。HBsAg 截断值≤100 IU/mL 预测 HBsAg 血清学清除的敏感性为 75%，特异性为 91%。基线血清 HBV DNA 不能预测 HBsAg 血清学清除；ROC 曲线下面积为 0.64（95% CI，0.46-0.81；P=0.13）。
单次血清 HBsAg 水平可预测 HBeAg 阴性慢性乙型肝炎患者 HBsAg 血清学清除的机会。
