血清 HBV RNA 水平可预测慢性 HBV 感染患者的显著肝纤维化。
Serum HBV RNA levels predict significant liver fibrosis in patients with chronic HBV infection.
机构信息
Department of Liver Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
Research Unit, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
出版信息
Discov Med. 2020 Mar-Apr;29(157):119-128.
BACKGROUND AND AIM
Recently, several studies demonstrated that serum HBV RNA levels were associated with liver disease progression in patients with chronic hepatitis B virus (HBV) infection. This study aimed to determine whether serum HBV RNA levels were correlated with liver fibrosis.
METHODS
319 treatment-naïve patients with chronic HBV infection were included. The correlation between serum HBV RNA levels and liver histological fibrosis stages was analyzed, and calculations of the area under the receiver operating curve (AUROC) were performed for serum HBV RNA.
RESULTS
Serum HBV RNA levels were an independent predictor for significant liver fibrosis both in HBeAg-positive patients (OR=0.514, p<0.001) and HBeAg-negative patients (OR=3.574, p<0.001). In 153 HBeAg-positive patients, HBV RNA had a better diagnostic performance than APRI and FIB-4 (AUROC of 0.77, 0.66, and 0.66 for HBV RNA, APRI, and FIB-4, respectively; p=0.045 for HBV RNA vs. APRI; p=0.043 for HBV RNA vs. FIB-4) for the diagnosis of significant liver fibrosis. In 166 HBeAg-negative patients, HBV RNA also had a better diagnostic performance than APRI and FIB-4 (AUROC of 0.78, 0.68, and 0.62 for HBV RNA, APRI, and FIB-4, respectively; p=0.036 for HBV RNA vs. APRI; p=0.003 for HBV RNA vs. FIB-4) for the diagnosis of significant liver fibrosis.
CONCLUSION
Serum HBV RNA levels were a more accurate noninvasive test than APRI and FIB-4 for the diagnosis of significant liver fibrosis in treatment-naïve patients with chronic HBV infection.
背景与目的
最近，几项研究表明，慢性乙型肝炎病毒（HBV）感染者的血清 HBV RNA 水平与肝病进展相关。本研究旨在确定血清 HBV RNA 水平是否与肝纤维化相关。
方法
纳入 319 例初治慢性 HBV 感染患者。分析血清 HBV RNA 水平与肝组织纤维化分期的相关性，并对血清 HBV RNA 进行受试者工作特征曲线（AUROC）计算。
结果
血清 HBV RNA 水平是 HBeAg 阳性患者（OR=0.514，p<0.001）和 HBeAg 阴性患者（OR=3.574，p<0.001）发生显著肝纤维化的独立预测因素。在 153 例 HBeAg 阳性患者中，HBV RNA 在诊断显著肝纤维化方面的表现优于 APRI 和 FIB-4（AUROC 分别为 0.77、0.66 和 0.66；HBV RNA 与 APRI 相比，p=0.045；HBV RNA 与 FIB-4 相比，p=0.043）。在 166 例 HBeAg 阴性患者中，HBV RNA 在诊断显著肝纤维化方面的表现也优于 APRI 和 FIB-4（AUROC 分别为 0.78、0.68 和 0.62；HBV RNA 与 APRI 相比，p=0.036；HBV RNA 与 FIB-4 相比，p=0.003）。
结论
与 APRI 和 FIB-4 相比，血清 HBV RNA 水平是初治慢性 HBV 感染患者诊断显著肝纤维化的一种更准确的非侵入性检测方法。
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