血清 HBV 大表面蛋白在 HBV 感染不同阶段的预测价值及慢性乙型肝炎患者的病毒学应答。

Prediction value of serum HBV large surface protein in different phases of HBV infection and virological response of chronic hepatitis B patients.

机构信息

Department of Laboratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China; Gene Diagnostic Laboratory, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China.

出版信息

Clin Chim Acta. 2018 Jun;481:12-19. doi: 10.1016/j.cca.2018.02.015. Epub 2018 Feb 14.

DOI:10.1016/j.cca.2018.02.015

PMID:29453971

Abstract

BACKGROUND

Serum HBV large surface protein (HBV-LP) is an envelope protein that has a close relationship with HBV DNA level. This study is to explore the prediction value of HBV-LP in different phase of HBV infection and during antiviral therapy in chronic hepatitis B (CHB) patients.

METHODS

A retrospective study was conducted in 2033 individuals, which included 1677 HBV infected patients in different phases and 356 healthy controls. HBV-LP, HBV serum markers and HBV DNA were detected by ELISA, CMIA and qRT-PCR, respectively. 85 CHB patients receiving PegIFNα or ETV were divided into virological response (VR) and partial virological response (PVR). The dynamic changes of HBV DNA and HBV-LP were observed.

RESULTS

The level of HBV-LP in 2033 individuals was shown as: HBeAg-positive hepatitis > HBeAg-positive infection > HBeAg-negative hepatitis > HBeAg-negative infection > healthy controls. HBV-LP was positive in all patients whose HBV DNA > 1.0E + 06 IU/ml. When HBsAg was <0.05 IU/ml or >1000 IU/ml, HBV DNAs were all negative if HBV-LP < 1.0 S/CO. When HBsAg was between 0.05 IU/ml and 1000 IU/ml, the consistency of HBV-LP with HBV DNA was 100% in case of HBV-LP > 4.0 S/CO in HBeAg-positive patients and HBV-LP > 2.0 S/CO in HBeAg-negative ones. During antiviral therapy, baseline HBV-LP was lower in VR patients than that in PVR patients. The optimal cut-off points to predict VR by baseline HBV-LP were 32.4 and 28.6 S/CO for HBeAg-positive and HBeAg-negative hepatitis patients, respectively.

CONCLUSIONS

HBV-LP may be a useful marker for distinguishing the different phases of HBV infection. Moreover, baseline HBV-LP level can be used for predicting VR of CHB patients.

摘要

背景

血清 HBV 大表面蛋白（HBV-LP）是一种包膜蛋白，与 HBV DNA 水平密切相关。本研究旨在探讨 HBV-LP 在 HBV 感染不同阶段及慢性乙型肝炎（CHB）患者抗病毒治疗中的预测价值。

方法

对 2033 例个体进行回顾性研究，其中包括 1677 例 HBV 感染不同阶段的患者和 356 例健康对照者。采用 ELISA、CMIA 和 qRT-PCR 分别检测 HBV-LP、HBV 血清标志物和 HBV DNA。85 例接受 PegIFNα或 ETV 治疗的 CHB 患者分为病毒学应答（VR）和部分病毒学应答（PVR）。观察 HBV DNA 和 HBV-LP 的动态变化。

结果

2033 例个体的 HBV-LP 水平如下：HBeAg 阳性肝炎> HBeAg 阳性感染> HBeAg 阴性肝炎> HBeAg 阴性感染>健康对照组。HBV DNA>1.0E+06 IU/ml 的所有患者 HBV-LP 均为阳性。当 HBsAg<0.05 IU/ml 或>1000 IU/ml 时，HBV-LP<1.0 S/CO 时 HBV DNA 均为阴性。当 HBsAg 在 0.05 IU/ml 至 1000 IU/ml 之间时，在 HBeAg 阳性患者中，HBV-LP>4.0 S/CO 且在 HBeAg 阴性患者中，HBV-LP>2.0 S/CO 时，HBV-LP 与 HBV DNA 的一致性为 100%。抗病毒治疗期间，VR 患者的基线 HBV-LP 低于 PVR 患者。HBV-LP 预测 HBeAg 阳性和 HBeAg 阴性肝炎患者 VR 的最佳截断值分别为 32.4 和 28.6 S/CO。