血清白蛋白、铁、铁蛋白和肝铁调素对慢性乙型肝炎患者 IFNα 治疗抗病毒疗效的预测价值。

Predictive Value of Serum Albumin, Iron, Ferritin, and Hepcidin for Antiviral Efficacy of IFNα Treatment in Patients with Chronic Hepatitis B.

机构信息

Department of Clinical Laboratory, the Second Affiliated Hospital of Anhui Medical University, Hefei, China.

Department of Clinical Laboratory, the Second Affiliated Hospital of Anhui Medical University, Hefei, China

出版信息

Ann Clin Lab Sci. 2024 Mar;54(2):217-223.

PMID:38802153

Abstract

OBJECTIVE

Interferon-α (IFNα) therapy has been an integral part of the current treatment for hepatitis B virus (HBV) infection. However, the exact effect of IFNα antiviral therapy on liver function and iron metabolism in patients with chronic hepatitis B (CHB) remains unclear. Here, we investigated the characteristics of changes in liver function and iron metabolism indexes in patients with chronic hepatitis B before and after IFNα treatment. Additionally, we determined their predictive value for the therapeutic response of IFNα treatment.

METHODS

In this study, 34 patients with CHB before and after IFNα treatment were enrolled. Serum levels of virological indicators, liver function, and iron metabolism markers were detected and analyzed in each patient. ROC curve analysis was performed to compare the predictive value of serum liver function and iron metabolism markers for the therapeutic response of IFN α treatment.

RESULTS

A significant decrease in serum HBV DNA (<0.001) and HBsAg (<0.001) was observed before and after IFNα treatment. Compared to the patients before IFNα treatment, patients after IFNα treatment showed a significant increase in serum albumin (ALB) (<0.05) and a significant decrease in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) (=0.003 and =0.034). These findings suggested that the synthetic function of the liver was improved, and liver inflammation was alleviated. Serum HEPC and serum ferritin (SF) levels in patients after IFNα treatment were significantly higher (<0.001, <0.001); however, serum iron (SI) levels were significantly lower (=0.005) than those in patients before IFNα treatment. These findings indicate that IFNα treatment regulated iron metabolism homeostasis in CHB patients. Combined liver function and iron metabolism markers, including ALB, SI, SF, and HEPC, had the highest predictive value for the therapeutic response of IFNα treatment for CHB.

CONCLUSION

IFNα treatment improved liver function and iron metabolism homeostasis in patients with CHB. Regular monitoring of serum ALB, SI, SF, and HEPC can help predict the therapeutic response of IFNα treatment for CHB.

摘要

目的

干扰素-α（IFNα）治疗一直是乙型肝炎病毒（HBV）感染当前治疗的重要组成部分。然而，IFNα 抗病毒治疗对慢性乙型肝炎（CHB）患者肝功能和铁代谢的确切影响仍不清楚。在这里，我们研究了 CHB 患者 IFNα 治疗前后肝功能和铁代谢指标的变化特征，并确定了它们对 IFNα 治疗反应的预测价值。

方法

本研究纳入了 34 例 IFNα 治疗前后的 CHB 患者。检测并分析了每位患者的血清病毒学指标、肝功能和铁代谢标志物。通过 ROC 曲线分析比较了血清肝功能和铁代谢标志物对 IFNα 治疗反应的预测价值。

结果

IFNα 治疗前后血清 HBV DNA（<0.001）和 HBsAg（<0.001）显著下降。与 IFNα 治疗前的患者相比，IFNα 治疗后的患者血清白蛋白（ALB）显著升高（<0.05），血清丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST）显著降低（=0.003 和 =0.034）。这表明肝脏的合成功能得到改善，炎症减轻。IFNα 治疗后患者的血清铁调素（HEPC）和血清铁蛋白（SF）水平显著升高（<0.001，<0.001）；然而，血清铁（SI）水平显著降低（=0.005）。这表明 IFNα 治疗调节了 CHB 患者的铁代谢稳态。包括 ALB、SI、SF 和 HEPC 在内的联合肝功能和铁代谢标志物对 IFNα 治疗 CHB 的疗效预测具有最高的预测价值。