低血清乙肝表面抗原水平可预测中国东部HBeAg阳性慢性乙型肝炎患者的代偿期肝硬化
Low Serum Hepatitis B Surface Antigen Level Predicts Compensated Cirrhosis Caused by Chronic Hepatitis B in HBeAg Positive Patients in East China.
作者信息
Jia Wen, Qi Xun, Ji Yan-Yan, Xun Yun-Hao, Wang Hong, Zhang Wen-Hong, Yang Jian-Hua, Wang Jin-Yu, Zhu Hao-Xiang, Mao Ri-Cheng, Zhang Ji-Ming
机构信息
Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China ; Department of Infectious Diseases, Jing'An District Centre, Shanghai Hospital, Fudan University, Shanghai, China.
Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
出版信息
Hepat Mon. 2015 Aug 30;15(8):e29183. doi: 10.5812/hepatmon.29183. eCollection 2015 Aug.
BACKGROUNDS
Serum hepatitis B surface antigen (HBsAg) levels are associated with fibrosis in patients with chronic hepatitis B (CHB) infection.
OBJECTIVES
The aim of our study was to evaluate serum HBsAg level as a biomarker for compensated cirrhosis in hepatitis B e antigen (HBeAg) positive CHB patients.
PATIENTS AND METHODS
Two-hundred and one HBeAg-positive Chinese CHB patients with or without cirrhosis were enrolled in this retrospective study. Cirrhosis was diagnosed based on liver biopsy. Furthermore, patients with decompensated cirrhosis were excluded. A statistical analysis was performed regarding the association between serum HBsAg level and compensated cirrhosis.
RESULTS
Patients with compensated cirrhosis had a significantly lower mean serum HBsAg level compared to those without cirrhosis (3.27 Log10 IU/mL VS 4.17 Log10 IU/mL, P < 0.001). Furthermore, examining the correlation with compensated cirrhosis revealed that lower level of serum HBsAg was a significant factor in multivariate analysis. The area under the receiver operating characteristics curve of serum HBsAg was 0.856 for compensated cirrhosis. A positive predictive value of 66.2% and negative predictive value of 90.7% were obtained with a cut-off value of < 3.60 Log10 IU/mL (4000 IU/mL) of serum HBsAg. Moreover, the rate of compensated cirrhosis increased to 75.0% after combining with APRI > 2.
CONCLUSIONS
In HBeAg positive CHB patients, low serum HBsAg level is a useful predictor of compensated cirrhosis.
背景
血清乙肝表面抗原（HBsAg）水平与慢性乙型肝炎（CHB）感染患者的肝纤维化有关。
目的
本研究旨在评估血清HBsAg水平作为乙肝e抗原（HBeAg）阳性CHB患者代偿期肝硬化生物标志物的价值。
患者与方法
本回顾性研究纳入了201例有或无肝硬化的HBeAg阳性中国CHB患者。肝硬化通过肝活检确诊。此外，排除失代偿期肝硬化患者。对血清HBsAg水平与代偿期肝硬化之间的关联进行了统计分析。
结果
与无肝硬化患者相比，代偿期肝硬化患者的平均血清HBsAg水平显著更低（3.27 Log10 IU/mL对4.17 Log10 IU/mL，P < 0.001）。此外，与代偿期肝硬化的相关性研究显示，血清HBsAg水平较低在多因素分析中是一个显著因素。血清HBsAg用于代偿期肝硬化的受试者工作特征曲线下面积为0.856。血清HBsAg临界值< 3.60 Log10 IU/mL（4000 IU/mL）时，阳性预测值为66.2%，阴性预测值为90.7%。此外，与APRI>2联合使用后，代偿期肝硬化的发生率增至75.0%。
结论
在HBeAg阳性CHB患者中，低血清HBsAg水平是代偿期肝硬化的有用预测指标。
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