Yang Jiezuan, Chen Jiajia, Ye Ping, Jin Linfeng, Wu Wei, Sheng Guoping, Li Lan-Juan
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
J Transl Med. 2014 Jun 25;12:183. doi: 10.1186/1479-5876-12-183.
Serum quantitative hepatitis B surface antigen (HBsAg) levels may be an important predictor of hepatitis B e antigen (HBeAg) seroconversion (SC) in HBeAg-positive chronic hepatitis B (CHB) patients during antiviral treatment. The pattern of HBsAg variation in CHB patients either with or without SC following tenofovir disoproxil fumarate (TDF) treatment is not clearly understood.
Twenty patients with full experimental data were enrolled, and liver biochemistry, serum HBV DNA, and circulating CD4+CD25+ regulatory T cell (Treg) levels were determined at baseline and every 12 weeks after the initiation of TDF treatment (for a total of 96 weeks). In addition, the relationship between HBsAg or HBeAg and alanine aminotransferase (ALT), HBV DNA and Treg levels in SC and non-SC patients was analyzed.
In all, 9 patients had undergone HBeAg seroconversion by week 72 of TDF treatment, and biochemical and virological indexes and Treg percentages declined to normal levels. Furthermore, the positive correlation between HBsAg and ALT, HBV DNA and Treg levels was significant for SC patients, but not for non-SC patients. However, for HBeAg, significant positive correlations were or not observed for both SC and non-SC patients.
The quantitation of HBsAg is a more useful indicator than HBeAg for distinguishing SC and non-SC patients during TDF treatment. Moreover, HBsAg may be related to immune regulatory property of CHB patients during antiviral treatment.
血清乙型肝炎表面抗原(HBsAg)定量水平可能是HBeAg阳性慢性乙型肝炎(CHB)患者抗病毒治疗期间HBeAg血清学转换(SC)的重要预测指标。富马酸替诺福韦二吡呋酯(TDF)治疗后CHB患者无论有无SC的HBsAg变化模式尚不清楚。
纳入20例有完整实验数据的患者,在基线及TDF治疗开始后每12周(共96周)测定肝脏生化指标、血清HBV DNA及循环CD4+CD25+调节性T细胞(Treg)水平。此外,分析了SC和非SC患者中HBsAg或HBeAg与丙氨酸氨基转移酶(ALT)、HBV DNA及Treg水平之间的关系。
TDF治疗至72周时,共有9例患者发生HBeAg血清学转换,生化和病毒学指标及Treg百分比降至正常水平。此外,SC患者中HBsAg与ALT、HBV DNA及Treg水平呈显著正相关,而非SC患者则无。然而,对于HBeAg,SC和非SC患者均未观察到显著正相关。
在TDF治疗期间,HBsAg定量比HBeAg更有助于区分SC和非SC患者。此外,HBsAg可能与CHB患者抗病毒治疗期间的免疫调节特性有关。