Zhou Pu, Dong Minhui, Wang Jinyu, Li Fahong, Zhang Jiming, Gu Jingwen
Huashan Worldwide Medical Center, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China.
Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China.
Exp Ther Med. 2018 Nov;16(5):3805-3812. doi: 10.3892/etm.2018.6685. Epub 2018 Sep 3.
The aim of the present study was to investigate the predictive value of baseline serum microRNA (miRNA)-125b for nucleos(t)ide analogues (NAs) in patients with chronic hepatitis B (CHB). A total of 66 patients with Be antigen (HBeAg)-positive CHB received NAs therapy for 144 weeks. Serum miRNA-125b levels were measured at the baseline, while hepatitis B virus (HBV) DNA, hepatitis B surface antigen (HBsAg) and alanine aminotransferase (ALT) levels were measured throughout treatment. Stepwise logistic regression analysis was performed to identify predictors of treatment response. The results indicated that baseline serum miR-125b (OR=4.377; P=0.006), HBsAg (OR=0.120; P=0.010), ALT >5× upper limit of normal (ULN; OR=11.726; P=0.018) and undetectable HBV DNA at week 24 (OR=7.828; P=0.021) were independent predictors of complete response (CR) at 144 weeks (CR is defined as HBV DNA <500 IU/ml and HBeAg seroconversion). The baseline serum miRNA-125b combined with baseline HBsAg level yielded an area under the receiver-operating curve of 0.852 in discriminating CR and non-CR at 144 week. The combination of baseline miRNA-125b ≥1.7 and ALT >5× ULN had a positive predictive value 80% for CR at 144 weeks. The combination of baseline miRNA-125b ≥1.7 and HbsAg ≤4.4 (log IU/ml) had a negative predictive value of CR at 144 weeks of 100%. Together, these results suggest that baseline miRNA-125b is a reliable predictor of HBeAg seroconversion following NAs treatment. The present study may be used as a basis for the use of baseline miRNA-125b to optimize treatment prior to NAs therapy.
本研究旨在探讨基线血清微小RNA(miRNA)-125b对慢性乙型肝炎(CHB)患者核苷(酸)类似物(NAs)治疗的预测价值。共有66例e抗原(HBeAg)阳性的CHB患者接受了144周的NAs治疗。在基线时检测血清miRNA-125b水平,在整个治疗过程中检测乙型肝炎病毒(HBV)DNA、乙型肝炎表面抗原(HBsAg)和丙氨酸氨基转移酶(ALT)水平。进行逐步逻辑回归分析以确定治疗反应的预测因素。结果表明,基线血清miR-125b(OR=4.377;P=0.006)、HBsAg(OR=0.120;P=0.010)、ALT>5倍正常上限(ULN;OR=11.726;P=0.018)以及第24周时检测不到HBV DNA(OR=7.828;P=0.021)是144周时完全缓解(CR,定义为HBV DNA<500 IU/ml且HBeAg血清学转换)的独立预测因素。基线血清miRNA-125b与基线HBsAg水平相结合,在区分144周时的CR和非CR方面,受试者工作特征曲线下面积为0.852。基线miRNA-125b≥1.7与ALT>5倍ULN的组合对144周时的CR的阳性预测值为80%。基线miRNA-125b≥1.7与HbsAg≤4.4(log IU/ml)的组合对144周时CR的阴性预测值为100%。总之,这些结果表明基线miRNA-125b是NAs治疗后HBeAg血清学转换的可靠预测指标。本研究可为在NAs治疗前使用基线miRNA-125b优化治疗提供依据。