J Hepatology: HBsAg的不同成分可预测HBeAg阳性慢性乙型肝炎患者治疗期间HBsAg的流失情况

2021-01-22 MedSci原创 MedSci原创

慢性乙型肝炎(CHB)病毒感染是全球性的公共卫生问题,全球估计有2.5亿慢性感染者。

      慢性乙型肝炎(CHB)病毒感染是全球性的公共卫生问题,全球估计有2.5亿慢性感染者。乙型肝炎病毒(HBV)感染相关的终末期肝病或肝细胞癌(HCC)会导致全球超过0.5–100万例死亡。在慢性HBV感染的治疗过程中,血清中HBV表面抗原(HBsAg)的丧失或血清转化被认为是功能性治愈的标志。HBsAg由大表面蛋白(LHBs),中表面蛋白(MHBs)和小表面蛋白(SHBs)组成,它们的相对比例与疾病阶段密切相关。因此,本项研究的目的是评估治疗过程中HBsAg成分变化与功能性治愈之间的关联。

 

 

      研究人员回顾性分析了83例乙肝患者。在接受核苷酸类似物(NA)治疗的64例患者中有17例患者达到HBsAg丢失,在接受聚乙二醇干扰素-α2a(PEG-IFN)治疗的19例患者中有3例达到HBsAg丢失。研究人员将无HBsAg丢失的63例患者作为对照组。对在治疗前和治疗过程中患者血清中的LHB,MHB和SHB进行定量分析,寻杂差异。

 

 

      研究结果发现,治疗前,继发HBsAg丢失的患者中MHBs水平显着低于无HBsAg丢失的患者( p = 0.005)。在治疗过程中,HBsAg丢失患者的MHBs和LHBs比例迅速下降,而仅有HBVe抗原血清转化或无血清反应的患者则没有下降。在所有HBsAg丢失的患者中,NA治疗的第6个月都无法检测到MHBs。 接受者操作特征分析显示,在NA治疗之前,MHBs的比例是HBsAg丢失的最佳早期预测指标(AUC = 0.726, p =0.019)。

 

 

      因此,通过本项研究证实HBsAg蛋白的定量分析有望作为预测早期治疗反应的新工具。这些评估可能有助于优化个体抗病毒治疗,提高慢性HBV感染患者的功能治愈率。

 

 

原始出处:

Maria Pfefferkorn. Et al. Composition of HBsAg is predictive of HBsAg loss during treatment in patients with HBeAg-positive chronic hepatitis B. Journal of Hepatology.2021.

 

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    0

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    2021-01-24 xiaoshitou
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    2021-01-24 gwc384
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    2021-01-22 13c30453m58暂无昵称

    学习

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