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乙型肝炎 e 抗原阳性慢性乙型病毒性肝炎患儿乙型肝炎核心相关抗原特征分析。

Characteristics analysis of hepatitis B core-related antigen in children with hepatitis B e antigen-positive chronic viral hepatitis B infection.

机构信息

Senior Department of Hepatology, The Fifth Medical Center of PLA General Hospital, Beijing, China.

出版信息

Eur J Gastroenterol Hepatol. 2024 Oct 1;36(10):1238-1242. doi: 10.1097/MEG.0000000000002812. Epub 2024 Jun 28.

Abstract

BACKGROUND

The objective of antiviral therapy for chronic viral hepatitis B infection (CHB) is to achieve a functional cure. An important viral marker in the serum of patients with CHB is the serum hepatitis B core-related antigen (HBcrAg). However, there is limited research on HBcrAg in juvenile patients with CHB. In this study, we aimed to investigate the correlation between serum HBcrAg and other hepatitis B virus (HBV) markers in children with CHB and its predictive significance for prognosis during antiviral therapy.

METHODS

A single-center retrospective study was conducted involving 79 children with CHB, aged between 0 and 16 years. All the children were treated with interferon [or combined nucleos(t)ide analogs] for 48 weeks. HBcrAg, hepatitis B surface antigen (HBsAg), and HBV DNA were measured before treatment, and at 12 and 48 weeks after treatment. The enrolled children were classified into the seroclearance group and the nonseroclearance group based on the therapeutic outcome.

RESULTS

HBsAg seroclearance was observed in 28 out of 79 patients and hepatitis B e antigen seroconversion without HBsAg seroclearance was observed in 14 out of 79 patients following the conclusion of the treatment, with baseline HBcrAg titer levels showing no statistical significance in both the seroclearance and nonseroclearance groups ( P  = 0.277). HBsAg and HBV DNA were positively correlated with HBcrAg in children with CHB ( R2  = 0.3289, 0.4388). The area under the receiver operating characteristic curve of the decrease in HBcrAg at 12 weeks of treatment as a predictor of seroclearance at 48 weeks of treatment, exhibited a value of 0.77.

CONCLUSION

A decrease in serum HBcrAg levels in children with hepatitis B serves as a prognostic indicator.

摘要

背景

慢性乙型肝炎病毒(HBV)感染抗病毒治疗的目标是实现功能性治愈。慢性乙型肝炎患者血清中的一个重要病毒标志物是血清乙型肝炎核心相关抗原(HBcrAg)。然而,针对青少年慢性乙型肝炎患者的 HBcrAg 研究有限。本研究旨在探讨儿童慢性乙型肝炎患者血清 HBcrAg 与其他乙型肝炎病毒标志物的相关性及其在抗病毒治疗期间对预后的预测意义。

方法

本研究采用单中心回顾性研究,纳入 79 例年龄在 0 至 16 岁之间的慢性乙型肝炎患儿。所有患儿均接受干扰素[或联合核苷(酸)类似物]治疗 48 周。治疗前及治疗后 12 周和 48 周检测 HBcrAg、乙型肝炎表面抗原(HBsAg)和 HBV DNA。根据治疗结果将患儿分为血清学应答组和非血清学应答组。

结果

79 例患儿中,28 例出现 HBsAg 血清学应答,14 例出现乙型肝炎 e 抗原血清学转换而无 HBsAg 血清学应答。治疗结束时,两组患儿的基线 HBcrAg 滴度均无统计学差异(P=0.277)。在慢性乙型肝炎患儿中,HBsAg 和 HBV DNA 与 HBcrAg 呈正相关(R2=0.3289,0.4388)。治疗 12 周时 HBcrAg 下降预测治疗 48 周时血清学应答的受试者工作特征曲线下面积为 0.77。

结论

乙型肝炎患儿血清 HBcrAg 水平下降可作为预后指标。

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