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乙型肝炎表面抗原水平识别了亚洲非活性的慢性乙型肝炎患者,其HCC风险低于监测值

Tai-Chung Tseng^1,2,3, Shang-Chin Huang^1,2,4,5, Mei-Hung Pan⁶

¹Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

|June 20, 2025

概括

在不活跃的慢性乙型肝炎 (CHB) 患者中,乙型肝炎表面抗原 (HBsAg) 水平低于100 IU/mL,表明肝癌 (HCC) 的风险可以忽略不计. 这一发现有助于优化监测和确定部分乙型肝炎病毒 (HBV) 治愈方法.

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 (CHB) 构成全球显著的健康风险,主要是由于与肝细胞癌 (HCC) 的关联.
识别不活跃的CHB和最小的HCC风险的患者对于有效的管理和治疗策略至关重要.
定义部分乙型肝炎病毒 (HBV) 治愈标准需要对病毒活性和癌症风险进行准确的评估.

研究的目的:

为了确定患有不活跃CHB的患者,他们患HCC的风险可以忽略不计.
利用乙型肝炎表面抗原 (HBsAg) 水平作为评估HCC风险和定义部分HBV治愈的关键标记.
为了验证使用HBsAg水平与氨酸转氨酶 (ALT) 结合用于风险分层,而不需要HBV DNA测试.

主要方法:

在ERADICATE-B和REVEAL-HBV队列中分析了2674名不活跃的CHB患者的数据.
主要终点是HCC的发展,HBsAg水平用于识别年HCC风险低于0.2%的患者.
使用NTUH-iMD队列验证发现,将HBsAg水平 (<100 IU/mL) 和正常的ALT与HC风险相关联.

主要成果:

在长达26.3年的中位数随访期间,76名患者患有HCC.
不活跃的HBsAg<100 IU/mL的CHB患者每年HCC发病率为0.08%,明显低于HBsAg≥100 IU/mL的患者.
结合正常ALT的HBsAg水平<100 IU/mL,有效地识别出患有可忽略的HCC风险的患者,与一般人群相比且低于监测值.

结论:

血清HBsAg水平<100 IU/mL是一个可靠的指标,用于识别具有微不足道的HCC风险的不活跃CHB患者.
这种标记标志着有限的病毒活性,对优化CHB的监测策略至关重要.
这些发现有助于确定部分HBV治愈的定义,通过精确确定风险和病毒载量最小的患者.

关键词:

这就是ALT ALT.在ERADICATE-B研究中,这就是HBV的DNA.这就是HBsAg.这就是Reveal-HBV的原因.肝癌肝癌是一种肝癌.

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