IP10和抗-HBc可预测慢性乙型肝炎患者停用核苷（酸）类似物后的病毒学复发和HBsAg清除。
IP10 and Anti-HBc can Predict Virological Relapse and HBsAg Loss in Chronic Hepatitis B Patients after Nucleos(t)ide Analog Discontinuation.
作者信息
Xie Yandi, Li Minghui, Ou Xiaojuan, Zheng Sujun, Gao Yinjie, Xu Xiaoyuan, Yang Ying, Ma Anlin, Li Jia, Nan Yuemin, Zheng Huanwei, Liu Juan, Wei Lai, Feng Bo
机构信息
Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis, Beijing, China,
Department of Hepatology Division, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
出版信息
Dig Dis. 2023;41(6):922-931. doi: 10.1159/000533515. Epub 2023 Aug 16.
INTRODUCTION
To assess predictive ability of serum interferon-inducible protein 10 (IP10) and hepatitis B core antibody (anti-HBc) levels for virological relapse (VR) and hepatitis B surface antigen (HBsAg) loss after nucleos(t)ide analog (NA) discontinuation.
METHODS
In this multicenter prospective study, overall 139 patients were followed up for 24 months after NA discontinuation.
RESULTS
End of treatment (EOT) IP10 and anti-HBc were 29.2 (5.1-66.4) pg/mL and 193.6 (136.9-221.4) IU/mL. EOT IP10 and anti-HBc were independent predictors for VR and HBsAg loss in Cox regression analysis. Cumulative rates of VR in patients with EOT IP10 > 26.99 pg/mL was 31.9% (vs. 70.1%, hazard ratio [HR] 2.998, p < 0.001). Cumulative incidences of VR in patients with EOT anti-HBc ≤141.35 IU/mL was 49.1% (vs. 60.6%, HR 2.99, p < 0.001). Cumulative probabilities of VR was 16.7% in patients with EOT IP10 > 26.99 pg/mL plus anti-HBc ≤141.35 IU/mL (vs. 73.6%, HR 6.464, p < 0.001). Cumulative probabilities of HBsAg loss in patients with EOT IP10 > 93.5 pg/mL was 46.2% (vs. 4.7%, HR 10.94, p < 0.001). Cumulative probabilities of HBsAg loss in patients with EOT anti-HBc ≤78.42 IU/mL were 47.1% (vs. 5%, HR 12.27, p < 0.001). Patients with EOT IP10 > 93.5 pg/mL plus anti-HBc ≤78.42 IU/mL had the highest 24-month cumulative HBsAg loss rate (53.8% vs. 4%, HR 16.83, p < 0.001).
CONCLUSION
High EOT IP10 and low EOT anti-HBc levels were related to both lower risk of VR and higher probability of HBsAg loss.
引言
评估血清干扰素诱导蛋白10（IP10）和乙肝核心抗体（抗-HBc）水平对核苷（酸）类似物（NA）停药后病毒学复发（VR）和乙肝表面抗原（HBsAg）消失的预测能力。
方法
在这项多中心前瞻性研究中，共139例患者在NA停药后随访24个月。
结果
治疗结束（EOT）时IP10和抗-HBc分别为29.2（5.1 - 66.4）pg/mL和193.6（136.9 - 221.4）IU/mL。在Cox回归分析中，EOT时的IP10和抗-HBc是VR和HBsAg消失的独立预测因素。EOT时IP10>26.99 pg/mL的患者VR累积发生率为31.9%（vs. 70.1%，风险比[HR] 2.998，p<0.001）。EOT时抗-HBc≤141.35 IU/mL的患者VR累积发生率为49.1%（vs. 60.6%，HR 2.99，p<0.001）。EOT时IP10>26.99 pg/mL且抗-HBc≤141.35 IU/mL的患者VR累积概率为16.7%（vs. 73.6%，HR 6.464，p<0.001）。EOT时IP10>93.5 pg/mL的患者HBsAg消失累积概率为46.2%（vs. 4.7%，HR 10.94，p<0.001）。EOT时抗-HBc≤78.42 IU/mL的患者HBsAg消失累积概率为47.1%（vs. 5%，HR 12.27，p<0.001）。EOT时IP10>93.5 pg/mL且抗-HBc≤78.42 IU/mL的患者24个月HBsAg消失累积率最高（53.8% vs. 4%，HR 16.83，p<0.001）。
结论
EOT时高IP10水平和低抗-HBc水平与较低的VR风险和较高的HBsAg消失概率相关。
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