First Clinical College, Fujian Medical University, Fuzhou, China; Department of Laboratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China; Fujian Key Laboratory of Laboratory Medicine, China.
Department of Laboratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China; Gene Diagnostic Laboratory, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China; Fujian Key Laboratory of Laboratory Medicine, China.
Clin Chim Acta. 2020 Mar;502:120-127. doi: 10.1016/j.cca.2019.12.020. Epub 2019 Dec 28.
Recently, the role of albumin-bilirubin (ALBI) score in chronic hepatitis B (CHB) has not been well-understood. We aimed to investigate the association of ALBI score with natural history of chronic HBV infection and treatment response of CHB patients.
The ALBI score in a cohort of 849 individuals including 721 chronic HBV-infected patients naïve to anti-HBV treatment in different phases and 128 healthy controls were estimated. Additionally, the dynamic changes of ALBI score of 243 hepatitis B e antigen (HBeAg)-positive CHB patients treated with pegylated interferon-alpha (PEG-IFN-α) or nucleos(t)ide analogues (NAs) were tested for 72 weeks.
ALBI score differed among phases, with the highest score in HBeAg-positive CHB patients, followed by HBeAg-negative CHB patients, HBeAg-positive chronic HBV infection, and HBeAg-negative chronic HBV infection. Besides, CHB patients harbouring high baseline ALBI score exhibited a relatively stronger therapeutic response to PEG-IFN-α or NAs. Moreover, the rate of HBeAg and HBsAg loss in patients with ALBI grade 2 was persistently higher than that in patients with ALBI grade 1 throughout the course of treatment. Furthermore, ALBI score was an independent predictor of sustained response achievement. The combined use of ALBI score, HBeAg and ALT could enhance the predictive value of treatment response.
ALBI score differed significantly across the natural course of chronic HBV infection and was correlated with PEG-IFN-α and NAs treatment response in HBeAg-positive CHB patients, which suggested that ALBI score could be useful as an auxiliary clinical factor to determine the initiation of therapy and predict stronger antiviral treatment response.
白蛋白-胆红素（ALBI）评分在慢性乙型肝炎（CHB）中的作用尚未得到充分了解。本研究旨在探讨 ALBI 评分与慢性乙型肝炎自然史和 CHB 患者治疗反应的关系。
在一个包括 721 例不同阶段未接受抗乙型肝炎病毒（HBV）治疗的慢性 HBV 感染者和 128 例健康对照者的队列中，评估了 ALBI 评分。此外，对 243 例 HBeAg 阳性 CHB 患者的 ALBI 评分进行了动态检测，这些患者接受聚乙二醇干扰素-α（PEG-IFN-α）或核苷（酸）类似物（NAs）治疗 72 周。
ALBI 评分在不同阶段有所不同，HBeAg 阳性 CHB 患者的评分最高，其次是 HBeAg 阴性 CHB 患者、HBeAg 阳性慢性 HBV 感染和 HBeAg 阴性慢性 HBV 感染。此外，基线 ALBI 评分较高的 CHB 患者对 PEG-IFN-α或 NAs 的治疗反应较强。此外，在治疗过程中，ALBI 分级 2 患者的 HBeAg 和 HBsAg 丢失率始终高于 ALBI 分级 1 患者。此外，ALBI 评分是获得持续应答的独立预测因子。ALBI 评分、HBeAg 和 ALT 的联合使用可以提高治疗反应的预测价值。
ALBI 评分在慢性乙型肝炎自然病程中差异显著，与 HBeAg 阳性 CHB 患者接受 PEG-IFN-α和 NAs 治疗反应相关，提示 ALBI 评分可作为辅助临床因素，用于确定治疗时机和预测更强的抗病毒治疗反应。
