Zhang P, Du H B, Tong G D, Li X K, Sun X H, Chi X L, Xing Y F, Zhou Z H, Li Q, Chen B, Wang H, Wang L, Jin H, Mao D W, Wang X B, Wu Q K, Li F P, Hu X Y, Lu B J, Yang Z Y, Zhang M X, Shi W B, He Q, Li Y, Jiang K P, Xue J D, Li X D, Jiang J M, Lu W, Tian G J, Hu Z B, Guo J C, Li C Z, Deng X, Luo X L, Li F Y, Zhang X W, Zheng Y J, Zhao G, Wang L C, Wu J H, Guo H, Mi Y Q, Gong Z J, Wang C B, Jiang F, Guo P, Yang X Z, Shi W Q, Yang H Z, Zhou Y, Sun N N, Jiao Y T, Gao Y Q, Zhou D Q, Ye Y A
Department of Gastroenterology and Hepatology, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China.
Institute of liver disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China.
J Viral Hepat. 2018 Sep;25(9):1017-1025. doi: 10.1111/jvh.12903. Epub 2018 May 11.
The kinetics of serum hepatitis B surface antigen (HBsAg) during the natural history of hepatitis B virus (HBV) infection has been studied, but the factors affecting them remain unclear. We aimed to investigate the factors affecting HBsAg titres, using data from multicentre, large-sized clinical trials in China. The baseline data of 1795 patients in 3 multicentre trials were studied, and the patients were classified into 3 groups: hepatitis B early antigen (HBeAg)-positive chronic HBV infection (n = 588), HBeAg-positive chronic hepatitis B (n = 596), and HBeAg-negative chronic hepatitis B (n = 611). HBsAg titres in the different phases were compared, and multiple linear progression analyses were performed to investigate the implicated factors. HBsAg titres varied significantly in different phases (P = .000), with the highest (4.60 log10 IU/mL [10%-90% confidence interval: 3.52 log10 IU/mL-4.99 log10 IU/mL]) in patients with HBeAg-positive chronic HBV infection. In all phases, age and HBV DNA were correlated with serum HBsAg level. In HBeAg-positive chronic hepatitis B patients, a negative correlation between HBsAg titres and fibrosis stage was observed. Alanine amonitransferase or necroinflammatory activity was also correlated with HBsAg titres in HBeAg-negative chronic hepatitis B patients. In conclusion, decreased HBsAg titres may be associated with advancing fibrosis in HBeAg-positive chronic hepatitis B patients or increased necroinflammation in those with HBeAg-negative chronic hepatitis B. Our findings may help clinicians better understand the kinetics of HBsAg and provide useful insights into the management of this disease.
人们已经对乙型肝炎病毒（HBV）感染自然史中血清乙型肝炎表面抗原（HBsAg）的动力学进行了研究，但影响其动力学的因素仍不清楚。我们旨在利用中国多中心大型临床试验的数据，调查影响HBsAg滴度的因素。研究了3项多中心试验中1795例患者的基线数据，并将患者分为3组：乙型肝炎e抗原（HBeAg）阳性慢性HBV感染（n = 588）、HBeAg阳性慢性乙型肝炎（n = 596）和HBeAg阴性慢性乙型肝炎（n = 611）。比较了不同阶段的HBsAg滴度，并进行了多元线性回归分析以调查相关因素。不同阶段的HBsAg滴度差异显著（P = .000），HBeAg阳性慢性HBV感染患者的滴度最高（4.60 log10 IU/mL [10%-90%置信区间：3.5——
