State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, China.
Department of Infectious Disease, Beilun People's Hospital, Ningbo, 315800, China.
BMC Infect Dis. 2022 Nov 11;22(1):842. doi: 10.1186/s12879-022-07841-1.
This study was designed to analyze the liver tissue changes among the CHB patients who received treatment for at least 6 months and follow-up for at least 1 year, together with the correlation between the different disease condition and serum markers.
One-hundred and eighty-five CHB patients underwent antiviral therapy for at least 6 months were enrolled. In the 12-month follow-up, ultrasonography-guided biopsy was performed. The patients were grouped based on the serum markers and pathological changes in liver tissues. Then we determined the serum markers, virological tests and Tim-3 expression among these groups.
Antiviral therapy significantly reduced liver inflammation indicators and serum Tim-3 level. However, the fibrosis process of liver tissue was not changed, and there are still disputes on the serum marker and hepatic lesion outcomes. Under normal liver function or negative hepatitis B e antigen (HBeAg) of CHB patients, there might be consensus between Tim-3 change and liver pathological outcome. According to the liver tissue inflammation and fibrosis conditions, Tim-3 was positively correlated with liver function indices. Besides, it was also related to fibrosis stage and inflammation grade.
There were inconsistent changes between serum markers and liver tissue conditions after anti-viral therapy. Tim-3 expression was more suitable to indicate the changes of liver inflammatory and fibrosis response to some extent than ALT and AST. It may serve as a certain indicator to predict the CHB prognosis, which could be used as one of the monitoring indicators in liver pathological changes of chronic HBV infection, especially in monitoring liver tissue inflammation.
本研究旨在分析接受至少 6 个月治疗并随访至少 1 年的 CHB 患者的肝组织变化,以及不同疾病状况与血清标志物之间的相关性。
纳入 185 例接受抗病毒治疗至少 6 个月的 CHB 患者。在 12 个月的随访中,进行了超声引导下肝活检。根据血清标志物和肝组织病理变化将患者分组。然后,我们测定了这些组中的血清标志物、病毒学检测和 Tim-3 表达。
抗病毒治疗显著降低了肝炎症指标和血清 Tim-3 水平。然而,肝组织纤维化过程没有改变,并且血清标志物和肝损伤结果仍存在争议。在正常肝功能或 CHB 患者阴性乙型肝炎 e 抗原 (HBeAg) 下,Tim-3 变化与肝病理结果之间可能存在共识。根据肝组织炎症和纤维化情况,Tim-3 与肝功能指标呈正相关。此外,它还与纤维化阶段和炎症程度有关。
抗病毒治疗后血清标志物和肝组织状况之间的变化不一致。Tim-3 的表达在一定程度上比 ALT 和 AST 更能反映肝炎症和纤维化反应的变化,它可能成为预测 CHB 预后的一定指标,可作为慢性乙型肝炎病毒感染肝组织病理变化监测的指标之一,尤其是在监测肝组织炎症方面。