在免疫耐受性患者中,乙型肝炎表面抗原的较高水平与肝细胞癌的延迟发展有关
Tai-Chung Tseng1,2,3, Tetsuya Hosaka4, Mei-Hung Pan5
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Hepatology (Baltimore, Md.)
|March 20, 2025
概括
在慢性乙型肝炎 (HBV) 感染中,高病毒载量会增加肝细胞癌 (HCC) 风险,特别是在HBeAg阴性患者中. 然而,免疫耐受性患者的高HBsAg水平可能会延迟HCC的发展.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒学 病毒学
- 在瘤学瘤学.
背景情况:
- 慢性乙型肝炎 (HBV) 感染构成肝细胞癌 (HCC) 的重大风险.
- 在免疫耐受性患者中,与高病毒载量相关的HCC确切风险仍然不完全理解.
- 这项研究调查了影响慢性HBV患者HCC发展的病毒因素,重点关注免疫耐受性阶段.
研究的目的:
- 为了澄清 HBV 病毒因子与慢性 HBV 感染中 HCC 风险之间的关系.
- 专门研究具有高病毒载荷的免疫耐受性患者的HCC风险.
- 根据HBeAg状态区分HBV DNA和HBsAg水平的预测作用.
主要方法:
- 分析了来自ERADICATE-B和REVEAL-HBV研究的6139名台湾慢性HBV患者.
- 作为主要终点,对HCC发展的纵向随访.
- 在HBeAg阳性和HBeAg阴性队列中单独分析病毒因子 (HBV DNA,HBsAg).
主要成果:
- 在21.7年的时间里,记录了547例HCC病例.
- 在HBeAg阴性患者中,HCC风险与HBVDNA相关,停滞在≥5 log10 IU/mL.
- 在HBeAg阴性患者中,HBsAg水平与HCC风险呈正相关性,但在HBeAg阳性患者中呈负相关性.
- 在免疫耐受性患者中,HBsAg水平≥10,000 IU/mL与HCC发病延迟有关,在子组和外部队列中得到验证.
结论:
- 根据HBeAg状态,HBV DNA和HBsAg水平对HCC发展具有不同的预测值.
- 免疫耐受性患者的HBsAg水平升高 (≥10,000 IU/mL) 与HCC发病延迟有关.
- HBsAg水平可以作为生物标志物来识别真正的免疫耐受性个体并分层HCC风险.
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