血清乙型肝炎病毒大、中表面蛋白作为预测 HBsAg 清除的新工具。
Serum hepatitis B virus large and medium surface proteins as novel tools for predicting HBsAg clearance.
机构信息
First Department of Liver Disease Center, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Third Department of Liver Disease Center, Beijing Youan Hospital, Capital Medical University, Beijing, China.
出版信息
Front Immunol. 2022 Sep 23;13:1028921. doi: 10.3389/fimmu.2022.1028921. eCollection 2022.
BACKGROUND
There is still lack of reliable predictors for hepatitis B surface antigen (HBsAg) clearance. Recent studies have shown that the levels of large (LHBs) and medium hepatitis B surface proteins (MHBs) are closely related to antiviral efficacy. This study aimed to investigate the possibility of LHB and MHB levels to predict HBsAg clearance.
METHODS
An inactive HBsAg carriers (IHCs) cohort that had received pegylated interferon (Peg-IFN) treatment was divided into the HBsAg-cleared group (R group) and the HBsAg non-cleared group (NR group) based on whether HBsAg was cleared at 96 weeks. We detected the levels of LHBs and MHBs to evaluate the possibility of predicting HBsAg clearance.
RESULTS
There were 39 patients in the R group and 21 in the NR group. The total HBsAg, LHB, and MHB levels at baseline and at 12 weeks were significantly lower in the R group than in the NR group (all p< 0.05). Multivariate logistic regression indicated that LHB and MHB levels at baseline and 12 weeks were independent predictors of HBsAg clearance (OR = 0.435, p = 0.016; OR = 0.136, p = 0.003; OR = 0.137, p = 0.033; OR = 0.049, p = 0.043). The area under the curve (AUC) for the baseline and 12-week LHB and MHB levels was 0.827-0.896, which were greater than that of the total HBsAg level at baseline and 12-week (AUC: 0.654-0.755). Compared with the prediction results of a single indicator, the combination of LHB and MHB levels had better value in predicting HBsAg clearance. The AUCs of combination factor 1, constructed from baseline LHB and MHB, and combination factor 2, constructed from 12-week LHB and MHB, were 0.922 and 0.939, respectively, and the sensitivity (82.05%-100.00%) and specificity (85.71%-100.00%) were both high. The combined indicators based on baseline LHBs ≤ 13.99 ng/mL and MHBs ≤ 7.95 ng/mL predicted HBsAg clearance rate of more than 90%.
CONCLUSION
Baseline and 12-week LHB and MHB levels can predict HBsAg clearance obtained by Peg-IFN therapy in IHCs, and the predictive value is higher than that of the total HBsAg levels.
背景
目前仍缺乏可靠的乙型肝炎表面抗原（HBsAg）清除预测因子。最近的研究表明，大（LHBs）和中乙型肝炎表面蛋白（MHBs）的水平与抗病毒疗效密切相关。本研究旨在探讨 LHB 和 MHB 水平预测 HBsAg 清除的可能性。
方法
将接受聚乙二醇干扰素（Peg-IFN）治疗的无活性 HBsAg 携带者（IHCs）队列根据 96 周时 HBsAg 是否清除分为 HBsAg 清除组（R 组）和 HBsAg 未清除组（NR 组）。我们检测了 LHBs 和 MHBs 的水平，以评估预测 HBsAg 清除的可能性。
结果
R 组有 39 例，NR 组有 21 例。R 组基线和 12 周时的总 HBsAg、LHB 和 MHB 水平均明显低于 NR 组（均 P<0.05）。多变量逻辑回归表明，基线和 12 周时的 LHB 和 MHB 水平是 HBsAg 清除的独立预测因子（OR=0.435，P=0.016；OR=0.136，P=0.003；OR=0.137，P=0.033；OR=0.049，P=0.043）。基线和 12 周时 LHB 和 MHB 水平的曲线下面积（AUC）为 0.827-0.896，大于基线和 12 周时总 HBsAg 水平的 AUC（0.654-0.755）。与单个指标的预测结果相比，LHB 和 MHB 水平的组合具有更好的 HBsAg 清除预测价值。由基线 LHB 和 MHB 构建的组合因子 1 和由 12 周 LHB 和 MHB 构建的组合因子 2 的 AUC 分别为 0.922 和 0.939，灵敏度（82.05%-100.00%）和特异性（85.71%-100.00%）均较高。基于基线 LHBs≤13.99ng/mL 和 MHBs≤7.95ng/mL 的联合指标预测 HBsAg 清除率超过 90%。
结论
基线和 12 周时的 LHB 和 MHB 水平可预测 IHCs 接受 Peg-IFN 治疗后的 HBsAg 清除，其预测价值高于总 HBsAg 水平。
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