不确定性慢性乙型肝炎不同类型的分布,特征和自然史:一项真实B型研究
Rui Huang1,2,3, Ai-Thien Do1,4,5, Hidenori Toyoda6
1Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California, USA.
Alimentary pharmacology & therapeutics
|May 21, 2025
概括
一半的慢性乙型肝炎 (CHB) 患者处于不确定的阶段,具有不同的类型和过渡概率. 不确定的CHB的管理需要基于特定患者类型的个性化护理.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒学 病毒学
- 临床医学 临床医学
背景情况:
- 慢性乙型肝炎 (CHB) 不确定的阶段代表了一个异质的患者群体.
- 了解不确定的CHB的患病率和特征对于有效管理至关重要.
研究的目的:
- 为了确定不确定的CHB的流行率.
- 描述新型的不确定的CHB的特征.
- 评估这些新型类型的相位过渡概率.
主要方法:
- 从9个国家24个中心的8375名CHB患者的回顾性招生.
- 基于AASLD 2018指南的无限期阶段的定义.
- 对患者人口统计,HBeAg状态,ALT水平和HBVDNA水平的分析.
主要成果:
- 47.2%的队列处于不确定的阶段.
- 最常见的HBeAg阳性不确定的类型:2型 (12.6%).
- 最常见的HBeAg阴性不确定的类型:6型 (30.1%).
- 10年过渡概率:6.5%为免疫耐受性,32.1%为免疫活性,64.3%为免疫不活性.
- 2型不确定的患者有73.2%的过渡到免疫活性阶段;8型有16.5%.
结论:
- 不确定的CHB可以分为10种类型.
- 6型 (HBeAg 阴性,HBV DNA ≥2000 IU/mL,ALT
- 2型 (HBeAg阳性,ALT 1-2xULN,HBV DNA ≥20,000 IU/mL) 最有可能过渡到免疫活性阶段 (73.2%).
- 建议基于不确定类型的CHB进行个性化监测和管理.
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