Heijtink R A, Kruining J, Honkoop P, Kuhns M C, Hop W C, Osterhaus A D, Schalm S W
Department of Virology, Erasmus University, Rotterdam, The Netherlands.
J Med Virol. 1997 Nov;53(3):282-7.
Hepatitis Be antigen (HBeAg) seroconversion is considered the principal short-term goal of antiviral therapy in chronic hepatitis B. To test whether the pre- and per-treatment HBeAg quantitation has a higher predictive value than that of hepatitis B virus DNA (HBV-DNA) quantitation for the outcome of antiviral therapy in chronic hepatitis B. A quantitative measurement of HBV-DNA and HBeAg (AxSYM HBe 2.0 Quantitative, Abbott Laboratories) was undertaken in serial serum samples from 30 patients with 16-week interferon-alpha (IFN-alpha) treatment (follow-up 36 weeks; 14 responders) and from 15 patients with 24-week lamivudine treatment (follow-up 24 weeks; 2 responders). In the group of interferon-treated patients, the median pretreatment HBV-DNA level was significantly lower in responders compared to nonresponders (P = 0.02); the difference in median HBeAg level was not significant. However, the percentage of response was significantly related (P = 0.003) to the magnitude of decline in HBeAg level between the start of therapy and week 4. This phenomenon was not observed for HBV-DNA. Using multivariate analysis, it was found that the fall of HBeAg levels between weeks 0 and 4 was the most important independent predictor of response. In the group of lamivudine treated patients, the rapid decline in HBV-DNA (> 90%) in 12 patients at week 4 had no relation to HBeAg seroconversion. In contrast, the fall in HBeAg-level (one patient with > 50% reduction at week 4 seroconverted) appears to be predictive. Quantitation of HBeAg at start and early during therapy may have clinically important predictive value for long-term response to antiviral therapy.
乙肝e抗原（HBeAg）血清学转换被认为是慢性乙型肝炎抗病毒治疗的主要短期目标。为了检验治疗前和治疗期间的HBeAg定量对于慢性乙型肝炎抗病毒治疗结果是否比乙肝病毒DNA（HBV-DNA）定量具有更高的预测价值。对30例接受16周α干扰素（IFN-α）治疗（随访36周；14例应答者）和15例接受24周拉米夫定治疗（随访24周；2例应答者）患者的系列血清样本进行了HBV-DNA和HBeAg定量检测（AxSYM HBe 2.0定量检测，雅培实验室）。在干扰素治疗组中，应答者治疗前HBV-DNA水平中位数显著低于无应答者（P = 0.02）；HBeAg水平中位数差异不显著。然而，应答率与治疗开始至第4周期间HBeAg水平下降幅度显著相关（P = 0.003）。HBV-DNA未观察到这种现象。采用多变量分析发现，第0周和第4周期间HBeAg水平下降是应答的最重要独立预测因素。在拉米夫定治疗组中，12例患者在第4周时HBV-DNA快速下降（> 90%）与HBeAg血清学转换无关。相反，HBeAg水平下降（1例患者在第4周时下降> 50%并发生血清学转换）似乎具有预测性。治疗开始时及治疗早期的HBeAg定量对于抗病毒治疗的长期应答可能具有重要的临床预测价值。
