Li Tao, Liu Feng, Zhang Lixin, Ye Qian, Fan Xiaoping, Xue Yan, Wang Lei
Department of Infectious Diseases and Hepatology, The Second Hospital of Shandong University, Shandong, China.
Department of Hepatopathy, Qingdao Infectious Disease Hospital, Shandong, China.
Saudi J Gastroenterol. 2018 Jan-Feb;24(1):30-36. doi: 10.4103/sjg.SJG_228_17.
BACKGROUND/AIMS: The optimal duration of nucleos(t)ide analogs (NAs) therapy in chronic hepatitis B (CHB) patients remains unsatisfactory. Previous studies have confirmed the important role of host genetic factors in determining the outcome of HBV infection. This study tries to determine the role of host genetic factors in predicting response status in CHB patients discontinuing NAs according to stringent cessation criteria.
Participating patients came from a prospective NAs- discontinuation cohort since June 1999. Six single-nucleotide polymorphisms (SNPs) were selected according to previous report. SNaPshot assay was used for DNA SNPs analyses.
Seventy-six CHB patients were enrolled in our study, of which 61 patients were HBeAg-positive and 15 patients were HBeAg-negative. rs1883832 in the Kozak sequence of CD40 displayed an AUROC of 0.778 in predicting response status in CHB patients with HBeAg seroconversion and a genotype of CT was associated with sustained response in this subpopulation. The diagnostic performance of combinative index (rs1883832, age, and HBsAg at discontinuation) seemed to be better than that of rs1883832, but no statistical difference was observed. rs1883832 was also evaluated as an independent factor for response status by multivariate logistic regression. For HBeAg-negative CHB patients, rs9277535 at HLA-DP presents a Spearman correlation coefficient of 0.582 (P = 0.023) with virological relapse after discontinuation of NAs.
rs1883832 serves as a valuable predictive factor for CHB patients with HBeAg seroconversion. rs9277535 at HLA-DP might also be a valuable predictive factor for CHB patients with HBeAg-negative, however, further verifications are recommended due to study limitations.
背景/目的:慢性乙型肝炎(CHB)患者中核苷酸类似物(NAs)治疗的最佳疗程仍不尽人意。既往研究已证实宿主遗传因素在决定HBV感染结局中的重要作用。本研究旨在根据严格的停药标准,确定宿主遗传因素在预测停用NAs的CHB患者应答状态中的作用。
参与研究的患者来自1999年6月起的一项前瞻性NAs停药队列。根据既往报道选择了6个单核苷酸多态性(SNP)。采用SNaPshot分析法进行DNA SNP分析。
76例CHB患者纳入本研究,其中61例HBeAg阳性,15例HBeAg阴性。CD40 Kozak序列中的rs1883832在预测HBeAg血清学转换的CHB患者应答状态时的曲线下面积(AUROC)为0.778,CT基因型与该亚组的持续应答相关。联合指标(rs1883832、年龄和停药时的HBsAg)的诊断性能似乎优于rs1883832,但未观察到统计学差异。通过多因素logistic回归分析,rs1883832也被评估为应答状态的独立因素。对于HBeAg阴性的CHB患者,HLA-DP的rs9277535与停用NAs后的病毒学复发的Spearman相关系数为0.582(P = 0.023)。
rs1883832是HBeAg血清学转换的CHB患者的一个有价值的预测因素。HLA-DP的rs9277535可能也是HBeAg阴性的CHB患者的一个有价值的预测因素,然而,由于研究局限性,建议进一步验证。