Kuo Yuan-Hung, Chang Kuo-Ching, Wang Jing-Houng, Tsai Pei-Shan, Hung Shu-Feng, Hung Chao-Hung, Lu Sheng-Nan
Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Health Center of Zihguan Township, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2015 Feb;31(2):102-7. doi: 10.1016/j.kjms.2014.11.002. Epub 2014 Dec 4.
This study was to elucidate longitudinally quantitative changes of hepatitis B virus (HBV) surface antigen (HBsAg) and HBV DNA in elder HBsAg carriers in a community. Among 1002 residents screened for HBsAg in 2005, 405 responded to this follow-up study in 2010. Fifty-nine (14.6%) were HBsAg carriers in 2005; HBsAg quantification and HBV DNA were measured. HBsAg quantification (cutoff 1600 IU/mL) and HBV DNA (cutoff 2000 IU/mL) were combined to stratify the participants between two screens. A total of 30 men and 29 women with a mean age of 63.9 ± 7.9 years were enrolled. Quantitative levels of HBsAg and HBV DNA were significantly correlated in 2005 (r = 0.509, p < 0.001) and 2010 (r = 0.777, p < 0.001). Concentrations of HBsAg (IU/mL) significantly decreased from 2.2 ± 1.0 log in 2005 to 1.7 ± 1.5 log in 2010 (p < 0.001). The level of HBsAg was decreased in 48 (81.4%) individuals and HBsAg was undetectable in eight (13.6%). The annual incidence of HBsAg clearance was 2.7%. These 59 HBsAg carriers in 2005 were divided into four groups: low HBsAg low HBV DNA (n = 32), high HBsAg low HBV DNA (n = 5), low HBsAg high HBV DNA (n = 12) and high HBsAg high HBV DNA (n = 10). All 32 individuals in the low HBsAg low HBV DNA group were still in that group in 2010, whereas only two of the high HBsAg high HBV DNA group became inactive. As with a younger cohort in hospital, HBsAg quantification was still well correlated with HBV DNA in elderly HBsAg carriers in the community. Lower levels of both HBsAg and HBV DNA might represent an inactive HBV infection.
本研究旨在纵向阐明社区中老年乙肝表面抗原（HBsAg）携带者体内乙肝病毒（HBV）表面抗原及HBV DNA的定量变化。在2005年筛查HBsAg的1002名居民中，405人在2010年参与了这项随访研究。2005年时，59人（14.6%）为HBsAg携带者；对其进行了HBsAg定量检测及HBV DNA检测。结合HBsAg定量检测（临界值1600 IU/mL）及HBV DNA检测（临界值2000 IU/mL）结果，将两次筛查之间的参与者进行分层。共纳入30名男性和29名女性，平均年龄为63.9±7.9岁。2005年及2010年时，HBsAg定量水平与HBV DNA均显著相关（2005年：r = 0.509，p < 0.001；2010年：r = 0.777，p < 0.001）。HBsAg浓度（IU/mL）从2005年的2.2±1.0 log显著降至2010年的1.7±1.5 log（p < 0.001）。48人（81.4%）的HBsAg水平下降，8人（13.6%）检测不到HBsAg。HBsAg清除的年发生率为2.7%。2005年的这59名HBsAg携带者被分为四组：低HBsAg低HBV DNA组（n = 32）、高HBsAg低HBV DNA组（n = 5）、低HBsAg高HBV DNA组（n = 12）和高HBsAg高HBV DNA组（n = 10）。低HBsAg低HBV DNA组的所有32人在2010年仍处于该组，而高HBsAg高HBV DNA组只有两人转为非活动性感染。与医院中的年轻队列一样，社区中老年HBsAg携带者中HBsAg定量与HBV DNA仍密切相关。较低水平的HBsAg和HBV DNA可能代表HBV感染呈非活动性。
