与乙型肝炎核心相关的抗原动力学预测慢性乙型肝炎患者的自发HBeAg血清
Hung-Yao Lin1,2, Kuan-Hui Hsin1, Chun-Jen Liu1,3,4
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Journal of gastroenterology
|October 11, 2025
概括
乙型肝炎核心相关抗原 (HBcrAg) 水平预测慢性乙型肝炎 (CHB) 患者的自发乙型肝炎e抗原 (HBeAg) 血清清除. 较低或下降的HBcrAg水平与实现HBeAg血清清除的可能性更高有关.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒学 病毒学
- 免疫学 免疫学 免疫学
背景情况:
- 乙型肝炎抗原 (HBeAg) 血清清除是治疗慢性乙型肝炎 (CHB) 的关键里程碑.
- 乙肝核心相关抗原 (HBcrAg) 水平对自发HBeAg血清清除的预测作用仍未得到充分研究.
研究的目的:
- 调查基线HBcrAg水平及其动态模式与未经治疗的CHB患者中自发HBeAg血清的相关性.
- 评估HBcrAg动力学在预测HBeAg血清清除中的有用性,特别是在免疫耐受性CHB患者中.
主要方法:
- 在484名先前未接受治疗的HBeAg阳性CHB患者的回顾性队列研究中.
- 延长后续期以确定自发HBeAg血清清除率.
- 与HBeAg血清清除相关的基线HBcrAg水平和HBcrAg动态模式 (基线与3年) 的分析.
主要成果:
- 在平均7.8年的随访期间,68.4%的患者实现了自发的HBeAg血清清除.
- 较低的基线HBcrAg水平与HBeAg血清清除的可能性增加显著相关 (P < .001).
- 患者的HBcrAg水平持续低于10^5KU/mL或下降到这一门,显示HBeAg血清清除的可能性明显更高 (HR:分别为2.66和2.31),即使在多变量分析后.
结论:
- 低于10^5 KU/mL的HBcrAg水平,或降至该水平,是CHB患者自发HBeAg血清清除的强有力的预测因素.
- 持续高的HBcrAg水平可能表明CHB的早期阶段,并可以告知临床管理策略.
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