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血浆干扰素-γ诱导蛋白 10 水平可作为慢性乙型肝炎患者乙型肝炎表面抗原自发清除的预测因子。

Plasma interferon-gamma-inducible-protein 10 level as a predictive factor of spontaneous hepatitis B surface antigen seroclearance in chronic hepatitis B patients.

机构信息

Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong.

State Key Laboratory of Liver Research, The University of Hong Kong, Hong Kong.

出版信息

J Gastroenterol Hepatol. 2024 Jan;39(1):202-209. doi: 10.1111/jgh.16371. Epub 2023 Oct 4.

Abstract

BACKGROUND AND AIM

Spontaneous seroclearance of hepatitis B surface antigen (HBsAg) is a rare event that occurs in patients that are chronically infected with the hepatitis B virus. As the functional cure and ultimate treatment endpoint of chronic hepatitis B (CHB), HBsAg seroclearance is an important milestone in the natural history of CHB and serves great clinical value. This study aims to identify host and viral factors associated with HBsAg seroclearance.

METHODS

This is a retrospective study carried out in the Queen Mary Hospital, Hong Kong. By analyzing the plasma retrieved from the serum archive (collected during 2011-2021) of 100 CHB patients attending the hospital's liver clinic, the longitudinal cytokine profiles between the HBsAg-losers and the control groups were compared.

RESULTS

Data revealed that plasma levels of IP-10 were significantly lower at 3-5 years prior to HBsAg seroclearance compared with patients who remained HBsAg positive (P < 0.05). Receiver operating characteristic curve analysis reveals that plasma IP-10 levels at multiple time points before HBsAg seroclearance return area under receivor-operating characteristic curve (AUC) greater than 0.7. Plasma IP-10 levels at 42.39 pg/mL produced an AUC = 0.723 with 74.0% sensitivity and 75.5% specificity to predict subsequent HBsAg seroclearance in the next 3-5 years. Low plasma IP-10 identified 91.4% patients with quantitative HBsAg < 100 IU/mL who would subsequently develop HBsAg seroclearance, compared with 37% with higher plasma IP-10 levels (P < 0.001).

CONCLUSIONS

Low plasma levels of IP-10 are associated with subsequent HBsAg seroclearance, suggesting potential clinical utilities of measurement of IP-10 in predicting HBsAg seroclearance, especially among patients with low HBsAg.

摘要

背景与目的

乙肝表面抗原(HBsAg)自发清除是慢性乙型肝炎(CHB)患者中罕见的事件。作为 CHB 的功能性治愈和最终治疗终点,HBsAg 清除是 CHB 自然史中的一个重要里程碑,具有重要的临床价值。本研究旨在确定与 HBsAg 清除相关的宿主和病毒因素。

方法

这是一项在香港玛丽医院进行的回顾性研究。通过分析从医院肝脏诊所就诊的 100 名 CHB 患者的血清档案中提取的血浆(收集于 2011 年至 2021 年期间),比较了 HBsAg 丢失者和对照组之间的纵向细胞因子谱。

结果

数据显示,与持续 HBsAg 阳性的患者相比,HBsAg 清除前 3-5 年血浆 IP-10 水平显著降低(P<0.05)。接受者操作特征曲线分析显示,HBsAg 清除前多个时间点的血浆 IP-10 水平返回的曲线下面积(AUC)大于 0.7。血浆 IP-10 水平为 42.39pg/mL 时,AUC=0.723,具有 74.0%的灵敏度和 75.5%的特异性,可预测未来 3-5 年内的 HBsAg 清除。低血浆 IP-10 识别出 91.4%的定量 HBsAg<100IU/mL 的患者随后会发生 HBsAg 清除,而高血浆 IP-10 水平的患者比例为 37%(P<0.001)。

结论

低血浆 IP-10 水平与随后的 HBsAg 清除相关,提示测量 IP-10 预测 HBsAg 清除具有潜在的临床应用价值,尤其是在 HBsAg 水平较低的患者中。

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