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乙型肝炎病毒感染自然史中定量HBsAg滴度的临床意义及其与HBV DNA水平的相关性

Clinical Significance of Quantitative HBsAg Titres and its Correlation With HBV DNA Levels in the Natural History of Hepatitis B Virus Infection.

作者信息

Karra Vijay K, Chowdhury Soumya J, Ruttala Rajesh, Polipalli Sunil K, Kar Premashis

机构信息

PCR Hepatitis Lab, Department of Medicine, Maulana Azad Medical College, University of Delhi, New Delhi 110002, India.

出版信息

J Clin Exp Hepatol. 2016 Sep;6(3):209-215. doi: 10.1016/j.jceh.2016.07.002. Epub 2016 Aug 3.

Abstract

BACKGROUND/OBJECTIVE: Quantification of serum hepatitis B antigen (HBsAg) is an important test that marks active infection with hepatitis B and helps in the prediction of the clinical outcome and management of hepatitis B virus (HBV) infection. Correlation with HBV DNA quantitative levels may help in developing strategies for antiviral treatment. This study is aimed to evaluate HBsAg titres in various phase of HBV infection in HBsAg positive patients, and its correlation with HBV DNA viral load levels.

METHODS

976 HBV related patients were analysed in this retrospective cross-sectional study. Patients were categorised on the basis of the phase of HBV infection: immune tolerant phase (IT,  = 123), immune clearance phase (IC,  = 192), low-replicative phase (LR,  = 476), and HBeAg-negative hepatitis (ENH,  = 185). HBsAg titres were quantified and correlated with HBV-DNA levels and clinical parameters.

RESULTS

Median HBsAg titres were different between each phases of HBV infection ( < 0.001): (4.62 log10 IU/ml), IC (3.88 log10 IU/ml), LR (2.76 log10 IU/ml) and ENH (2.94 log10 IU/ml). HBsAg and HBV DNA levels showed significant correlation in the whole group ( = 0.694,  < 0.001), and this was also observed in different phases of HBV infection. Strong correlation in IT phase ( = 0.603,  < 0.001) and IC phase ( = 0.523,  < 0.001), moderate in LR phase ( = 0.362,  < 0.001) and weak in ENH ( = 0.110,  = 0.04). No correlation was observed between serum HBsAg levels and biochemical parameters.

CONCLUSION

The study demonstrated significant difference in the median baseline values of serum HBsAg titres in different phases of HBV infection and provides additional information in understanding the natural history of HBV-infection.

摘要

背景/目的:血清乙肝表面抗原(HBsAg)定量检测是一项重要检查,可标记乙肝病毒的活跃感染情况,并有助于预测乙肝病毒(HBV)感染的临床结局及指导治疗。与HBV DNA定量水平的相关性可能有助于制定抗病毒治疗策略。本研究旨在评估HBsAg阳性患者HBV感染各阶段的HBsAg滴度,及其与HBV DNA病毒载量水平的相关性。

方法

在这项回顾性横断面研究中,对976例HBV相关患者进行了分析。根据HBV感染阶段对患者进行分类:免疫耐受期(IT,n = 123)、免疫清除期(IC,n = 192)、低复制期(LR,n = 476)和HBeAg阴性肝炎(ENH,n = 185)。对HBsAg滴度进行定量,并与HBV-DNA水平及临床参数进行相关性分析。

结果

HBV感染各阶段的HBsAg滴度中位数存在差异(P < 0.001):IT期为(4.62 log10 IU/ml),IC期为(3.88 log10 IU/ml),LR期为(2.76 log10 IU/ml),ENH期为(2.94 log10 IU/ml)。HBsAg与HBV DNA水平在整个研究组中显示出显著相关性(r = 0.694,P < 0.001),在HBV感染的不同阶段也观察到这种相关性。在IT期相关性较强(r = 0.603,P < 0.001),IC期次之(r = 0.523,P < 0.001),LR期为中度相关(r = 0.362,P < 0.001),ENH期相关性较弱(r = 0.110,P = 0.04)。血清HBsAg水平与生化参数之间未观察到相关性。

结论

该研究表明,HBV感染不同阶段血清HBsAg滴度的基线中位数存在显著差异,为理解HBV感染的自然史提供了更多信息。

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