Value of combined baseline serum HBV markers in predicting HBeAg seroconversion in chronic hepatitis B patients treated by nucleos(t)ide analogues
10.3969/j.issn.1001-5256.2023.05.011
- VernacularTitle:基线HBV血清标志物联合评分对核苷(酸)类似物抗病毒治疗慢性乙型肝炎患者HBeAg血清学转换的预测价值
- Author:
Yang WANG
1
;
Hao LIAO
2
;
Zhongping DENG
3
,
4
;
Jing ZHAO
1
;
Dandan BIAN
5
;
Yan REN
1
;
Yingying JIANG
1
;
Shuang LIU
1
;
Yu CHEN
1
;
Fengmin LU
6
;
Zhongping DUAN
1
;
Sujun ZHENG
1
Author Information
1. Liver Disease Center, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China
2. Department of Clinical Laboratory, Shenzhen Third People's Hospital & The Second Affiliated Hospital of Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases, Shenzhen, Guangdong 518112, China
3. Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China
4. Hunan Key Laboratory of Gene Diagnostic Technology, Changsha 410205, China
5. Department of Infectious Diseases, Electric Power Teaching Hospital, Capital Medical University, Beijing 100073, China
6. Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China
- Publication Type:Original Article_Viral Hepatitis
- Keywords:
Hepatitis B, Chronic;
Nucleosides;
Nucleotides;
Biomarkers;
Hepatitis B e Antigens;
Seroconversion
- From:
Journal of Clinical Hepatology
2023;39(5):1070-1075
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the ability of combined baseline serum markers, i.e., HBV DNA, HBV RNA, HBsAg, and HBcrAg, to predict HBeAg seroconversion in patients with HBeAg-positive chronic hepatitis B (CHB) treated by nucleos(t)ide analogues. Methods A retrospective analysis was performed for 83 HBeAg-positive patients selected as subjects from the prospective CHB follow-up cohort established by Difficult & Complicated Liver Diseases and Artificial Liver Center, Beijing YouAn Hospital, Capital Medical University, from June 2007 to July 2008, and the baseline serum levels of HBV DNA, HBV RNA, HBsAg, and HBcrAg were analyzed. The t -test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. The Spearman method was used for correlation analysis. A Cox regression model was established to calculate HBeAg seroconversion prediction score, and the time-dependent receiver operating characteristic curve was used to evaluate the ability of combined markers in predicting HBeAg seroconversion. The Kaplan-Meier method was used to calculate cumulative seroconversion rate in each group, and the Log-rank test was used for comparison between groups. Results For the 83 HBeAg-positive patients, the median follow-up time was 108 months, and 44.58%(37/83) of these patients achieved HBeAg seroconversion. Compared with the non-seroconversion group, the HBeAg seroconversion group had significantly lower baseline serum levels of HBV DNA [6.23(1.99-9.28) log 10 IU/mL vs 7.69(2.05-8.96) log 10 IU/mL, Z =-2.345, P =0.019] and HBV RNA [4.81(1.40-7.53) log 10 copies/mL vs 6.22(2.00-8.49) log 10 copies/mL, Z =-1.702, P =0.010], and there were no significant differences in the levels of HBsAg and HBcrAg between the two groups ( P > 0.05). The Cox regression equation constructed based on the above serum markers showed a median score of 0.95(range 0.37-3.45) for predicting HBeAg seroconversion. In the total population, the combined score was negatively correlated with HBsAg, HBV DNA, HBV RNA, and HBcrAg ( r =-0.697, -0.787, -0.990, and -0.819, all P < 0.001). Based on the median prediction score, the patients were divided into high HBeAg seroconversion group and low HBeAg seroconversion group; as for the prediction of HBeAg seroconversion rate at 36, 60, and 84 months, the high HBeAg seroconversion group had a seroconversion rate of 43.90%, 51.20%, and 63.10%, respectively, while the low HBeAg seroconversion group had a seroconversion rate of 9.60%, 17.00%, and 19.8%, respectively, and there was a significant difference between the two groups ( χ 2 =11.6, P < 0.001). Conclusion The combined prediction score based on baseline serum HBV markers can predict HBeAg seroconversion in CHB patients treated by nucleos(t)ide analogues.
