Hepatitis B Surface Antigen Quantification across Different Phases of Chronic Hepatitis B Virus Infection Using an Immunoradiometric Assay
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background/Aims: Quantification of hepatitis B surface antigen (HBsAg) is an emerging serologic test and may be useful for identifying treatment strategies for chronic hepatitis B (CHB). This study aimed to evaluate HBsAg titers during the natural course of CHB and identify correlations between HBsAg titers and hepatitis B virus (HBV) DNA concentrations across different CHB phases measured using an immunoradiometric assay (IRMA). Methods: CHB phases were defined on the basis of HBV DNA concentrations, the presence of hepatitis B e antigen/antibody (HBeAg/Ab) and serum alanine aminotransferase levels. Serum HBsAg titers and paired HBV DNA concentrations in the different phases of CHB were compared using 627 serum samples. Results: Mean HBsAg titers were significantly higher in the immunotolerant (IT) phase and immunoreactive (IR) HBeAg-positive phase than in the low-replicative (LR) and HBeAg-negative CHB (ENH) states. The correlation between HBsAg titers and HBV DNA concentrations was modest in the IT (n=36, r=0.804, p<0.001) and IR (n=48, r=0.773, p<0.001) phases, and it was poor in the LR state (n=116, r=0.289, p=0.002); however, no significant correlation was observed in the ENH state (n=67, r=0.146, p=0.237) or in the oral nucleos(t)ide analogue-treated group (n=267). Conclusions: HBsAg quantification using IRMA might be useful for discriminating different CHB phases and different stages of chronic liver disease.
Abstract
Background/Aims: Quantification of hepatitis B surface antigen (HBsAg) is an emerging serologic test and may be useful for identifying treatment strategies for chronic hepatitis B (CHB). This study aimed to evaluate HBsAg titers during the natural course of CHB and identify correlations between HBsAg titers and hepatitis B virus (HBV) DNA concentrations across different CHB phases measured using an immunoradiometric assay (IRMA). Methods: CHB phases were defined on the basis of HBV DNA concentrations, the presence of hepatitis B e antigen/antibody (HBeAg/Ab) and serum alanine aminotransferase levels. Serum HBsAg titers and paired HBV DNA concentrations in the different phases of CHB were compared using 627 serum samples. Results: Mean HBsAg titers were significantly higher in the immunotolerant (IT) phase and immunoreactive (IR) HBeAg-positive phase than in the low-replicative (LR) and HBeAg-negative CHB (ENH) states. The correlation between HBsAg titers and HBV DNA concentrations was modest in the IT (n=36, r=0.804, p<0.001) and IR (n=48, r=0.773, p<0.001) phases, and it was poor in the LR state (n=116, r=0.289, p=0.002); however, no significant correlation was observed in the ENH state (n=67, r=0.146, p=0.237) or in the oral nucleos(t)ide analogue-treated group (n=267). Conclusions: HBsAg quantification using IRMA might be useful for discriminating different CHB phases and different stages of chronic liver disease.
참고문헌 (45)
- Lavanchy D, "Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures", J Viral Hepat, 11, pp.97~107 (2004)
- Lok AS, "Chronic hepatitis B", Hepatology, 45, pp.507~539 (2007)
- Liaw YF, "Lamivudine for patients with chronic hepatitis B and advanced liver disease", N Engl J Med, 351, pp.1521~1531 (2004)
- 이초이, "Efficacy and Safety of Tenofovir-Based Rescue Therapy for Chronic Hepatitis B Patients with Previous Nucleo(s", t)ide Treatment Failure, 2014, pp.8(1), 64~69[DOI]
- 권대훈, "Continuous Long-Term Entecavir Therapy in Naïve Chronic Hepatitis B Patients Showing Partial Virologic Response", Gut and Liver, 7(6), pp.712~718 (2013), 거트앤리버 발행위원회
- Idilman R, "Hepatitis B surface antigen seroconversion is associated with favourable long-term clinical outcomes during lamivudine treatment in HBeAg-negative chronic hepatitis B patients", J Viral Hepat, 19, pp.220~226 (2012)
- European Association for the Study of the Liver, "EASL clinical practice guidelines: management of chronic hepatitis B", J Hepatol, 50, pp.227~242 (2009)
- Wursthorn K, "Peginterferon alpha-2b plus adefovir induce strong cccDNA decline and HBsAg reduction in patients with chronic hepatitis B", Hepatology, 44, pp.675~684 (2006)
- Volz T, "Impaired intrahepatic hepatitis B virus productivity contributes to low viremia in most HBeAg-negative patients", Gastroenterology, 133, pp.843~852 (2007)
- Chan HL, "Prediction of off-treatment response to lamivudine by serum hepatitis B surface antigen quantification in hepatitis B e antigen-negative patients", Antivir Ther, 16, pp.1249~1257 (2011)
- Liang Y, "Predictors of relapse in chronic hepatitis B after discontinuation of anti-viral therapy", Aliment Pharmacol Ther, 34, pp.344~352 (2011)
- Ganji A, "Correlation between HBsAg quantitative assay results and HBV DNA levels in chronic HBV", Hepat Mon, 11, pp.342~345 (2011)
- Lee JH, "Correlation between quantitative serum HBsAg and HBV DNA test in Korean patients who showed high level of HBsAg", J Clin Pathol, 63, pp.1027~1031 (2010)
- Moucari R, "Quantification of hepatitis B surface antigen: a new concept for the management of chronic hepatitis B", Liver Int, 31(1), pp.122~128 (2011)
- Nguyen T, "Hepatitis B surface antigen levels during the natural history of chronic hepatitis B: a perspective on Asia", J Hepatol, 52, pp.508~513 (2010)
- Chan HL, "A longitudinal study on the natural history of serum hepatitis B surface antigen changes in chronic hepatitis B", Hepatology, 52, pp.1232~1241 (2010)
- Jaroszewicz J, "Hepatitis B surface antigen (HBsAg) levels in the natural history of hepatitis B virus (HBV)-infection: a European perspective", J Hepatol, 52, pp.514~522 (2010)
- Thompson AJ, "Serum hepatitis B surface antigen and hepatitis B e antigen titers: disease phase influences correlation with viral load and intrahepatic hepatitis B virus markers", Hepatology, 51, pp.1933~1944 (2010)
- 강건욱, "Quantitative Measurement of Serum Hepatitis B Surface Antigen Using an Immunoradiometric Assay in Chronic Hepatitis B", Nuclear Medicine and Molecular Imaging, 45(1), pp.15~20 (2011), 대한핵의학회
- Kim H, "Comparison of the Abbott Architect i2000 assay, the Roche Modular Analytics E170 assay, and an immunoradiometric assay for serum hepatitis B virus markers", Ann Clin Lab Sci, 37, pp.256~259 (2007)
- Wursthorn K, "Correlation between the Elecsys HBsAg II assay and the Architect assay for the quantification of hepatitis B surface antigen (HBsAg) in the serum", J Clin Virol, 50, pp.292~296 (2011)
- European Association for the Study of the Liver, "EASL clinical practice guidelines: management of chronic hepatitis B virus infection", J Hepatol, 57, pp.167~185 (2012)
- 조지현, "B형간염바이러스 유전자형의 국내 분포에 대한 연구", Clinical and Molecular Hepatology, 15(2), pp.140~147 (2009), 대한간학회
- Song BC, "Hepatitis B virus genotypes in Korea: an endemic area of hepatitis B virus infection", Intervirology, 48, pp.133~137 (2005)
- Lee JM, "Quantification of HBsAg: basic virology for clinical practice", World J Gastroenterol, 17, pp.283~289 (2011)
- Ganem D, "Hepatitis B virus infection: natural history and clinical consequences", N Engl J Med, 350, pp.1118~1129 (2004)
- Ribeiro RM, "Dynamics of hepatitis B virus infection", Microbes Infect, 4, pp.829~835 (2002)
- Dienes HP, "Hepatic expression patterns of the large and middle hepatitis B virus surface proteins in viremic and nonviremic chronic hepatitis B", Gastroenterology, 98, pp.1017~1023 (1990)
- Lau JY, "Export of intracellular HBsAg in chronic hepatitis B virus infection is related to viral replication", Hepatology, 14, pp.416~421 (1991)
- Thimme R, "CD8(+) T cells mediate viral clearance and disease pathogenesis during acute hepatitis B virus infection", J Virol, 77, pp.68~76 (2003)
- Liaw YF, "Hepatitis flares and hepatitis B e antigen seroconversion: implication in anti-hepatitis B virus therapy", J Gastroenterol Hepatol, 18, pp.246~252 (2003)
- Chu CM, "Precore stop mutant in HBeAg-positive patients with chronic hepatitis B: clinical characteristics and correlation with the course of HBeAg-to-anti-HBe seroconversion", J Clin Microbiol, 40, pp.16~21 (2002)
- Yuen MF, "Relationship between the development of precore and core promoter mutations and hepatitis B e antigen seroconversion in patients with chronic hepatitis B virus", J Infect Dis, 186, pp.1335~1338 (2002)
- Liaw YF, "Incidence, determinants and significance of delayed clearance of serum HBsAg in chronic hepatitis B virus infection: a prospective study", Hepatology, 13, pp.627~631 (1991)
- Chan HL, "Serum hepatitis B surface antigen quantitation can reflect hepatitis B virus in the liver and predict treatment response", Clin Gastroenterol Hepatol, 5, pp.1462~1468 (2007)
- Fattovich G, "Long-term outcome of chronic hepatitis B in Caucasian patients: mortality after 25 years", Gut, 57, pp.84~90 (2008)
- Hsu YS, "Long-term outcome after spontaneous HBeAg seroconversion in patients with chronic hepatitis B", Hepatology, 35, pp.1522~1527 (2002)
- Chu CM, "HBsAg seroclearance in asymptomatic carriers of high endemic areas: appreciably high rates during a long-term follow-up", Hepatology, 45, pp.1187~1192 (2007)
- Manno M, "Natural history of chronic HBV carriers in northern Italy: morbidity and mortality after 30 years", Gastroenterology, 127, pp.756~763 (2004)
- Tseng TC, "High levels of hepatitis B surface antigen increase risk of hepatocellular carcinoma in patients with low HBV load", Gastroenterology, 142, pp.1140~1149 (2012)
- Tseng TC, "Serum hepatitis B surface antigen levels help predict disease progression in patients with low hepatitis B virus loads", Hepatology, 57, pp.441~450 (2013)
- Brunetto MR, "Hepatitis B virus surface antigen levels: a guide to sustained response to peginterferon alfa-2a in HBeAg-negative chronic hepatitis B", Hepatology, 49, pp.1141~1150 (2009)
- Moucari R, "Early serum HBsAg drop: a strong predictor of sustained virological response to pegylated interferon alfa-2a in HBeAg-negative patients", Hepatology, 49, pp.1151~1157 (2009)
- 권정현, "The Efficacy and Safety of Peginterferon-α-2a in Korean Patients with Chronic Hepatitis B: A Multicenter Study Conducted in a Real Clinical Setting", Gut and Liver, 7(2), pp.197~205 (2013), 거트앤리버 발행위원회
- Seto WK, "Reduction of hepatitis B surface antigen levels and hepatitis B surface antigen seroclearance in chronic hepatitis B patients receiving 10 years of nucleoside analogue therapy", Hepatology, 58, pp.923~931 (2013)
