与乙型肝炎表面抗原血清转化在慢性乙型肝炎中正相关的因素
Matthias Buechter1,2, Arne Maria Günther1, Paul Manka3
1Department of Gastroenterology and Hepatology, University Clinic of Essen, University of Duisburg-Essen, 45147 Essen, Germany.
Journal of personalized medicine
|April 27, 2024
概括
预测乙型肝炎e抗原 (HBeAg) 血清转化对于治疗慢性乙型肝炎病毒 (HBV) 感染至关重要. 低HBVDNA水平的未经治疗的男性显示出实现HBsAg血清转换的可能性最高.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒学 病毒学
- 免疫学 免疫学 免疫学
背景情况:
- 慢性乙型肝炎病毒 (HBV) 感染影响全球超过2.5亿人,构成重大公共卫生挑战.
- 确定HBsAg血清转换的生物标志物可以帮助临床决策,特别是因为并非所有患者都是抗病毒治疗的候选人.
研究的目的:
- 在慢性乙型肝炎患者队列中确定与HBsAg血清转化相关的因素.
- 评估HBV DNA和HBsAg水平对血清转换的预测值.
主要方法:
- 在2005年至2020年期间治疗的371名慢性乙型肝炎患者的回顾性分析.
- 统计分析以确定患者特征,病毒载量,HBsAg水平和血清转化之间的相关性.
- 确定HBVDNA和HBsAg的最佳切断值,以预测血清转化.
主要成果:
- 在6.7%的患者中发生HBsAg血清转化,7.8%的患者发生HBsAg损失.
- 抗病毒治疗与血清转换的可能性较低有关 (p=0.027).
- 低HBVDNA标位 (≤357 IU/mL) 和低定量HBsAg水平 (≤33.55 IU/mL) 与更高的血清转化率 (p<0.0005) 有意义地相关. 男性性别也显示出与血清转换的积极关联 (p=0.036).
结论:
- 之前没有接受过治疗的男性慢性HBV患者,病毒载量和炎症活性较低,对HBsAg血清转化有最好的预后.
- 在这种特定的患者群体中,抗病毒疗法可能不适合,特别是在没有肝硬化的情况下,以潜在地增强自然血清转化.
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