Liu Yiqi, Nuersulitan Reyizha, Zhang Chi, Huo Na, Li Jun, Song Yuqin, Zhu Jun, Liu Weiping, Zhao Hong
Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, No. 8 XishiKu Street, Xicheng District, Beijing 100034, China.
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Medical Oncology, Peking University Cancer Hospital & Institute, Beijing 100143, China.
J Clin Med. 2023 Dec 19;13(1):23. doi: 10.3390/jcm13010023.
Patients with lymphoma and chronic hepatitis B virus infection need to be treated with both chemotherapy and nucleotide analogue (NA) therapy. However, dynamic changes in HBV DNA loads with increasing chemotherapy cycles are lacking. It is unknown whether HBV replication markers, namely, the quantitative hepatitis B core antibody (qAnti-HBc), HBV RNA, and the hepatitis B virus core-related antigen (HBcrAg), are also markers for predicting HBV reactivation (HBVr). From 29 June 2010 to 6 December 2021, the data of patients with single-site diffuse large B-cell lymphoma and HBV infection (HBsAg+ and HBsAg-/anti-HBc+) were collected from a hospital medical record system, retrospectively. Serum HBV DNA loads (using real-time fluorescent quantitative PCR tests), qAnti-HBc levels (using a newly developed chemiluminescent particle immunoassay), HBV RNA levels (using the simultaneous amplification testing method based on real-time fluorescence detection), and HBcrAg levels (using a Lumipulse G HBcrAg assay) were tested, and factors related to HBVr were analyzed. Under NAs, the HBV DNA loads of 69 HBsAg+ lymphoma patients declined from 3.15 (2.13-4.73) lg IU/mL to 1.00 (1.00-1.75) lg IU/mL, and further declined to 1.00 (1.00-1.04) lg IU/mL at the end of a 24-month follow-up. The qAnti-HBc levels decreased gradually during chemotherapy in HBsAg+ lymphoma patients (F = 7.090, = 0.009). The HBV RNA and HBcrAg levels remained stable. A multivariate analysis revealed that higher qAnti-HBc levels (1.97 ± 1.20 vs. 1.12 ± 0.84 lg IU/mL, OR = 6.369, [95% CI: 1.523-26.641], = 0.011) and higher HBV RNA levels (1.00 ± 1.13 vs. 0.37 ± 0.80 lg copies/mL, OR = 3.299, [95% CI: 1.229-8.854], = 0.018) were related to HBVr in HBsAg-/anti-HBc+ lymphoma patients. HBV DNA loads declined under NAs during chemotherapy in lymphoma patients. In HBsAg-/anti-HBc+ lymphoma patients, a higher level of baseline serum qAnti-HBc and HBV RNA levels can predict the likelihood of HBVr during chemotherapy.
淋巴瘤合并慢性乙型肝炎病毒感染的患者需要同时接受化疗和核苷酸类似物（NA）治疗。然而，目前缺乏随着化疗周期增加乙肝病毒脱氧核糖核酸（HBV DNA）载量的动态变化情况。尚不清楚乙肝病毒复制标志物，即定量乙型肝炎核心抗体（qAnti-HBc）、HBV RNA和乙肝病毒核心相关抗原（HBcrAg）是否也是预测乙肝病毒再激活（HBVr）的标志物。2010年6月29日至2021年12月6日，从医院病历系统中回顾性收集单部位弥漫性大B细胞淋巴瘤合并HBV感染（HBsAg阳性和HBsAg阴性/抗-HBc阳性）患者的数据。检测血清HBV DNA载量（采用实时荧光定量聚合酶链反应检测）、qAnti-HBc水平（采用新开发的化学发光微粒免疫分析）、HBV RNA水平（采用基于实时荧光检测的同步扩增检测方法）和HBcrAg水平（采用Lumipulse G HBcrAg检测法），并分析与HBVr相关的因素。在NA治疗下，69例HBsAg阳性淋巴瘤患者的HBV DNA载量从3.15（2.13 - 4.73）lg IU/mL降至1.00（1.00 - 1.75）lg IU/mL，并在24个月随访结束时进一步降至1.00（1.00 - 1.04）lg IU/mL。HBsAg阳性淋巴瘤患者化疗期间qAnti-HBc水平逐渐下降（F = 7.090，P = 0.009）。HBV RNA和HBcrAg水平保持稳定。多因素分析显示，在HBsAg阴性/抗-HBc阳性淋巴瘤患者中，较高的qAnti-HBc水平（1.97 ± 1.20 vs. 1.12 ± 0.84 lg IU/mL，OR = 6.369，[95%置信区间：1.523 - 26.641]，P = 0.011）和较高的HBV RNA水平（1.00 ± 1.13 vs. 0.37 ± 0.80 lg拷贝/mL，OR = 3.299，[95%置信区间：1.229 - 8.854]，P = 0.018）与HBVr相关。淋巴瘤患者化疗期间在NA治疗下HBV DNA载量下降。在HBsAg阴性/抗-HBc阳性淋巴瘤患者中，较高的基线血清qAnti-HBc水平和HBV RNA水平可预测化疗期间HBVr的可能性。
