在治疗结束时,B型肝炎核心相关抗原水平较高,预测在停止核子侧面模拟疗法后,肝炎爆发
Simon J Hume1,2,3, Danny K Wong4, Man-Fung Yuen4
1St Vincent's Hospital Melbourne, Fitrozy, Victoria, Australia.
概括
血清乙型肝炎核心相关抗原 (HBcrAg) 水平预测了核类相应物 (NA) 治疗中止后的结果. 高HBcrAg表明肝炎爆发的风险和HBsAg损失的可能性很低,认为患者不适合停止NA治疗.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒学 病毒学
- 生物标志物发现发现
背景情况:
- 需要准确的生物标志物来预测慢性乙型肝炎患者中核酸类比 (NA) 疗法停止后的结果.
- 血清乙型肝炎核心相关抗原 (HBcrAg) 是预测治疗结果的潜在生物标志物.
研究的目的:
- 评估血清HBcrAg水平作为NA停药后临床结果的预测生物标志物.
- 评估HBcrAg在识别患有肝炎爆发风险的患者和不太可能达到HBsAg损失的患者中的实用性.
主要方法:
- 一项前性试验,涉及HBeAg阴性慢性乙型肝炎患者,没有肝硬化,正在接受NA停药.
- 在治疗结束 (EOT) 和治疗结束时测量血清HBcrAg,HBsAg,HBV RNA和HBV DNA.
- 预测关键的临床结果,包括肝炎爆发,生化复发,病毒学复发和HBsAg损失.
主要成果:
- 在86%的参与者中,HBcrAg可检测到.
- 在EOT预测的肝炎爆发时,HBcrAg水平≥4 log U/mL (80%对比31%,p=.001).
- 高HBcrAg或可检测的HBVRNA在EOT预测生化复发和肝炎爆发. 没有参与者具有EOT HBcrAg ≥4 log U/mL的HBsAg损失.
结论:
- 高血清HBcrAg水平与NA停止后肝炎爆发的风险增加有关.
- 升高的HBcrAg水平表明在96周内实现HBsAg损失的可能性很低.
- 患有高HBcrAg水平的患者由于不良结果的风险,不适合停止NA治疗.
相关概念视频
Diseases of the Liver and Gallbladder
Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not related to...
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not related to...
Hepatic Drug Excretion: Influencing Factors
The biliary system of the liver, crucial for bile secretion and drug excretion, comprises intrahepatic bile ducts that merge to form the common hepatic duct. This duct, carrying hepatic bile, combines with the cystic duct, draining the gallbladder and forming the common bile duct, which empties into the duodenum. Bile, produced by hepatic cells lining the bile canaliculi, is composed primarily of water, bile salts, pigments, electrolytes, and lesser amounts of cholesterol and fatty acids. Bile...
Hepatitis
Hepatitis is an inflammatory condition of the liver most commonly caused by hepatotropic viruses (A–E), though non-infectious causes such as alcohol and drugs also exist.Hepatitis AHepatitis A virus (HAV) is a non-enveloped RNA virus of the Picornaviridae family. It is primarily transmitted via the fecal-oral route, typically through ingestion of contaminated food or water. After ingestion, HAV enters the bloodstream through the oropharynx or intestinal epithelium and reaches the liver. The...
Inhibitors of Viral Protein Synthesis
Protein synthesis is indispensable for viral replication, as viruses lack the cellular machinery required for this process and must hijack the host's translational apparatus. In response, host cells deploy a critical innate immune defense involving interferons, specialized cytokines that play a central role in inhibiting viral propagation.Upon viral detection, infected cells release interferons that bind to receptors on adjacent uninfected cells, activating the JAK-STAT signaling pathway and...
Antiviral Nucleoside Inhibitors
Antiviral Nucleoside InhibitorsAntiviral nucleoside inhibitors are structural analogs of natural nucleosides that interfere with viral DNA or RNA synthesis. These compounds selectively target viral polymerases due to their resemblance to host nucleosides, thereby disrupting viral genome replication.Mechanism of Acyclovir ActionAcyclovir is a guanosine analog with a three-carbon acyclic side chain. It selectively targets herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2),...
Viral Hepatitis I: Introduction
Viral hepatitis is an inflammatory condition of the liver caused by infection with hepatotropic viruses, most commonly hepatitis A, B, C, D, and E. Despite variations in structure and transmission, all viruses mentioned infect hepatocytes and provoke immune responses that can hinder liver function. Additionally, some non-hepatotropic viruses can also lead to hepatic inflammation.Hepatitis A VirusHepatitis A virus (HAV) is transmitted through the fecal–oral route, typically by ingestion of food...


