预测乙型肝炎核心相关抗原在慢性乙型肝炎治疗终止后多次复发结果的预测值:一项元分析研究
Guoyang Yu1, Meiqi Cheng1, Yuxin Duan1
1Department of Laboratory Medicine, Naval Medical Centre, Naval Medical University, Shanghai 200052, China.
Viruses
|July 30, 2025
概括
乙型肝炎核心相关抗原 (HBcrAg) 在预测慢性乙型肝炎 (CHB) 抗病毒治疗后复发方面表现有前途. 这种生物标志物具有很高的灵敏度,有助于CHB患者停止治疗的决定.
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:
- 关于乙型肝炎核心相关抗原 (HBcrAg) 对预测慢性乙型肝炎 (CHB) 抗病毒治疗后复发的实用性存在相互矛盾的证据.
- HBcrAg反映了肝脏内共封闭圆形DNA (cccDNA) 活性,这是CHB持久性的关键因素.
研究的目的:
- 系统地评估HBcrAg在预测抗病毒治疗后CHB患者复发中的临床效用.
- 为了确定HBcrAg对病毒学复发,临床复发和肝炎爆发的诊断性能.
主要方法:
- 通过2025年4月对来自主要数据库 (PubMed, Web of Science, Wanfang, CNKI) 的13项研究 (15个队列,n=1529) 进行系统审查和元分析.
- 两变元分析模型来评估HBcrAg对复发结果的预测性能.
- 亚组分析和元回归以调查异质性和影响因素.
主要成果:
- 在复发预测方面,HBcrAg的综合敏感度为0.81,特异性为0.72,总体AUC为0.83.
- 诊断几率比为10.66,表明具有显著的预测价值.
- 异质性主要是由于值效应,并且在排除异常切线值时得到解决;预测值不受患者人口统计学或检测方法的影响.
结论:
- 在CHB中,HBcrAg被验证为一个强大的非侵入性生物标志物,用于优化治疗终止策略.
- 它的高灵敏度提供了强大的负预测值,对患者管理至关重要.
- 未来的研究应该探索多标志物模型,以进一步提高CHB复发的预测准确性.
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