慢性乙型肝炎自然史中乙肝核心抗体水平的特征

Characteristics of hepatitis B core antibody level in the natural history of chronic hepatitis B.

作者信息

Wang Jian, Yan Xiaomin, Chen Yuxin, Liu Yong, Wang Li, Jia Bei, Wang Guiyang, Xiong Yali, Song Peixin, Wu Weihua, Xia Juan, Lu Sufang, Zhang Zhaoping, Huang Rui, Wu Chao

机构信息

Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu 210008, China.

Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu 210008, China.

出版信息

Discov Med. 2018 Oct;26(143):119-125.

PMID:30586535

Abstract

OBJECTIVE

We aimed to analyze serum antibody to hepatitis B core antigen (anti-HBc) level during different immunological phases in the natural history of patients with chronic hepatitis B (CHB).

METHODS

Serum anti-HBc levels in the immune tolerant (IT), immune clearance (IC), low replicative (LR), and HBeAg negative hepatitis (ENH) phases from 634 treatment-naïve CHB patients were measured and compared between phases and with other serum markers.

RESULTS

Median serum anti-HBc levels were different between the phases of CHB. Serum anti-HBc level was highest in the ENH phase and lowest in the IT phase. Serum anti-HBc level correlated only with ALT in the IC phase (r = 0.248, p < 0.001). The area under the receiver operating characteristic curve (AUC) of anti-HBc at a cutoff value of 9.03 S/CO for differentiation of IT and IC phases was 0.689 (sensitivity 74.03%, specificity 60.23%). The AUC for differentiation of LR and ENH phases was 0.751 (sensitivity 68.32%, specificity 70.53%) at a cutoff value of 9.74 S/CO for anti-HBc.

CONCLUSIONS

Serum anti-HBc levels were significantly different across different phases of CHB and were associated with hepatitis activities.

摘要

目的

我们旨在分析慢性乙型肝炎（CHB）患者自然史中不同免疫阶段的血清乙型肝炎核心抗原抗体（抗-HBc）水平。

方法

检测634例未经治疗的CHB患者在免疫耐受（IT）、免疫清除（IC）、低复制（LR）和HBeAg阴性肝炎（ENH）阶段的血清抗-HBc水平，并在各阶段之间以及与其他血清标志物进行比较。

结果

CHB各阶段的血清抗-HBc中位数水平不同。血清抗-HBc水平在ENH阶段最高，在IT阶段最低。血清抗-HBc水平仅在IC阶段与ALT相关（r = 0.248，p < 0.001）。抗-HBc在区分IT和IC阶段时，截断值为9.03 S/CO时的受试者操作特征曲线（AUC）面积为0.689（敏感性74.03%，特异性60.23%）。抗-HBc在区分LR和ENH阶段时，截断值为9.74 S/CO时的AUC面积为0.751（敏感性68.32%，特异性70.53%）。