Wang Hua-Bin, Wang Qiong-Yu, Yuan Qing, Shan Xiao-Yun, Fu Guan-Hua
Department of Clinical Laboratory, Jinhua Central Hospital, Jinhua, China.
Wenzhou Medical College, Wenzhou, China.
J Clin Lab Anal. 2017 Nov;31(6). doi: 10.1002/jcla.22141. Epub 2017 Jan 23.
A direct correlation between hepatitis B virus DNA (HBV-DNA) and liver markers has not been identified in chronic hepatitis B (CHB) patients. However, the effect of HBV-DNA changes on liver markers remains unclear. We explored the association between decreased HBV-DNA and liver makers in CHB patients.
Chronic hepatitis B patients who visited Jinhua Central Hospital twice were selected for analysis. Finally, 171 participants with a 1-log reduction in HBV-DNA between the two visits were enrolled as the case group, and 158 participants with no significant changes in HBV-DNA were enrolled as the control group.
There was no significant correlation between HBV-DNA and liver markers (P>.05). However, in longitudinal analysis, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transpeptidase (GGT) were significantly different between the two tests (P<.05) in the case group. Conversely, there was no significant difference in the control group. When HBV-DNA decreased >26 times, ALT was reduced by half or more. A similar trend was observed with a decrease of >63 times for AST and a decrease of >76 times for GGT.
A large change in HBV-DNA can lead to a significant variation in liver markers. In particular, ALT was more sensitive than other liver markers to a reduction in HBV-DNA.
慢性乙型肝炎(CHB)患者中,尚未发现乙肝病毒脱氧核糖核酸(HBV-DNA)与肝脏标志物之间存在直接关联。然而,HBV-DNA变化对肝脏标志物的影响仍不明确。我们探讨了CHB患者HBV-DNA降低与肝脏标志物之间的关联。
选取两次前往金华市中心医院就诊的慢性乙型肝炎患者进行分析。最终,将两次就诊期间HBV-DNA下降1个对数的171名参与者纳入病例组,将HBV-DNA无显著变化的158名参与者纳入对照组。
HBV-DNA与肝脏标志物之间无显著相关性(P>0.05)。然而,纵向分析显示,病例组两次检测之间丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)和γ-谷氨酰转肽酶(GGT)存在显著差异(P<0.05)。相反,对照组无显著差异。当HBV-DNA下降>26倍时,ALT降低一半或更多。AST下降>63倍和GGT下降>76倍时也观察到类似趋势。
HBV-DNA的大幅变化可导致肝脏标志物出现显著变化。特别是,ALT对HBV-DNA降低比其他肝脏标志物更敏感。