中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

高灵敏度血清病毒学指标检测在低病毒载量乙型肝炎人群中的应用价值

谷九莲 刘守胜 李昌飞 肖剑寒 辛永宁 宣世英

引用本文:
Citation:

高灵敏度血清病毒学指标检测在低病毒载量乙型肝炎人群中的应用价值

DOI: 10.3969/j.issn.1001-5256.2018.06.037
基金项目: 

青岛市市立医院(集团)总院长新技术、新项目创新研究基金(VIII院ZYZJJ2017013); 

详细信息
  • 中图分类号: R512.62

Value of highly sensitive serum virological markers in hepatitis B patients with a low viral load

Research funding: 

 

  • 摘要: HBV的检测对于乙型肝炎的预防和治疗至关重要。临床研究发现一些乙型肝炎患者即使血清HBV DNA和HBs Ag检测阴性,病情仍会进展至肝硬化和肝细胞癌,所以迫切需要提高HBV检测的灵敏度,并发展新的检测技术和检测标志物。近年来人们逐渐意识到血清学和血清病毒学指标在低病毒载量乙型肝炎人群中的重要应用价值。主要总结了血清高灵敏度HBV DNA检测、HBs Ag、HBV RNA及血清HBcr Ag等在低病毒载量乙型肝炎人群中的临床应用价值。认为临床医生应结合乙型肝炎患者的病情及上述各项指标的检测水平与变化以指导该类人群的临床管理,最终达到治愈乙型肝炎的目的。

     

  • [1]SHAO GH, YAN XQ, CHEN HM, et al.The clinical signiifcance of high sensitivity HBV DNA detection for the treatment of antiviral therapy in patients with chronic hepatitis B[J/CDJ].Chin J Exp Clin Infect Dis:Electronic Edition, 2016, 10 (1) :46-48. (in Chinese) 邵国辉, 闫香芹, 陈合民, 等.高灵敏度HBV DNA检测指导慢性乙型肝炎患者抗病毒治疗的临床意义[J/CD].中华实验和临床感染病杂志:电子版, 2016, 10 (1) :46-48.
    [2]CHEN HM, SHAO GH.Criteria for withdrawal of nucleos (t) ide analogues and their clinical significance in treatment of chronic hepatitis B[J].J Clin Hepatol, 2016, 32 (7) :1283-1286. (in Chinese) 陈合民, 邵国辉.核苷和核苷酸类药物治疗慢性乙型肝炎停药标准的探讨[J].临床肝胆病杂志, 2016, 32 (7) :1283-1286.
    [3] ZHOU DQ, LIU CY, WANG CY, et al.The clinical significance of detection HBV DNA by high sensitivity method used in the diagnosis and treatment of hepatitis B[J].Med Inf, 2013, 26 (15) :221-222. (in Chinese) 周冬青, 刘成永, 王春颖, 等.高灵敏度乙肝HBV DNA检测在乙肝诊疗中的应用及临床意义[J].医学信息, 2013, 26 (15) :221-222.
    [4]JIANG JN, HUANG ZL, HE LX, et al.Residual amount of HBV DNA in serum is related to relapse in chronic hepatitis B patients after cessation of nucleos (t) ide analogs[J].J Clin Gastroenterol, 2015, 49 (4) :323-328.
    [5]ARI A, CALIK S, TOSUN S, et al.A persistently low HBV DNA level is a predictor of spontaneous HBsA g clearance in patients with chronic hepatitis B[J].Turk J Med Sci, 2016, 46 (1) :48-52.
    [6]LOK AS, McM AHON BJ.Chronic hepatitis B:Update 2009[J].Hepatology, 2009, 50 (3) :661-662.
    [7]HOU J, WANG G, WANG F, et al.Guideline of prevention and treatment for chronic hepatitis B (2015 update) [J].J Clin Transl Hepatol, 2017, 5 (4) :297-318.
    [8]European Association for the Study of the Liver.EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection[J].J Hepatol, 2017, 67 (2) :370-398.
    [9]ZHUANG H, WENG XH.Discussion of discontinuation of nucleoside and nucleoside analogs in the treatment of chronic hepatitis B[J].Chin J Viral Dis, 2013, 3 (4) :241-244. (in Chinese) 庄辉, 翁心华.核苷 (酸) 类似药物治疗慢性乙型肝炎停药的探讨[J].中国病毒病杂志, 2013, 3 (4) :241-244.
    [10]ZOU HX, WANG JH, CUI HL, et al.The relativity study between abnormal serum markers of hepatitis B and HBV-DNA[J].Int J Virol, 2017, 27 (4) :239-242. (in Chinese) 邹红霞, 王金环, 崔海玲, 等.乙型肝炎异常血清学诊断模式与HBV-DNA载量的相关性研究[J].国际病毒学杂志, 2017, 27 (4) :239-242.
    [11]CHEN Y, ZHONG BY, XU GY, et al.Determination of low level HBsA g in serum by MEIA[J].Chin J Lab Med, 2001, 24 (1) :39-41. (in Chinese) 陈瑜, 钟步云, 徐根云, 等.低水平血清乙肝病毒表面抗原测定及其临床意义[J].中华检验医学杂志, 2001, 24 (1) :39-41.
    [12]SHEN XY, FENG XJ.Measurement of low level HBsA g and its correlation with HBV-DNA[J].Chin J Nosocomiol, 2012, 22 (24) :5463-5465. (in Chinese) 沈小英, 冯雪君.低水平乙型肝炎表面抗原测定与HBV-DNA关系的研究[J].中华医院感染学杂志, 2012, 22 (24) :5463-5465.
    [13]LI MW.Serum HBV DNA and Hepatitis B surface antigen levels help predict diseases progression in patients with low hepatitis B virus loads[D].Hangzhou:Zhejiang Univ, 2014. (in Chinese) 李敏伟.HBV-DNA及HBsA g定量对低病毒载量慢性乙肝的临床意义[D].杭州:浙江大学, 2014.
    [14]YANG Y, GAO J, TAN YT, et al.Individual and combined effects of hepatitis B surface antigen level and viral load on liver cancer risk[J].J Gastroenterol Hepatol, 2018, 33 (5) :1131-1137.
    [15]LIANG Y, JIANG J, SU M, et al.Predictors of relapse in chronic hepatitis B after discontinuation of anti-viral therapy[J].Aliment Pharmacol Ther, 2011, 34 (3) :344-352.
    [16]SHI YR, QI YJ, YUE L, et al.Low viral load of hepatitis B virus and expression of serum markers[J].Anhui Med Pharm J, 2016, 20 (2) :346-348. (in Chinese) 石玉如, 戚应杰, 岳莉, 等.乙型肝炎病毒低病毒载量与血清标志物表达研究[J].安徽医药, 2016, 20 (2) :346-348.
    [17]LI J, SUN X, FANG J, et al.Analysis of intrahepatic total HBV DNA, cccD NA and serum HBsA g level in chronic hepatitis B patients with undetectable serum HBV DNA during oral antiviral therapy[J].Clin Res Hepatol Gastroenterol, 2017, 41 (6) :635-643.
    [18]WU YZ.Correlation analysis of quantitative HBsA g and liver histological features of HBeA g-negative chronic hepatitis B patients[J].J Clin Hepatol, 2012, 28 (12) :923-925. (in Chinese) 吴玉卓.HBsA g定量与HBeA g阴性慢性乙型肝炎患者肝脏组织学相关性分析[J].临床肝胆病杂志, 2012, 28 (12) :923-925.
    [19]WANG H, RU GQ, YAN R, et al.Histologic disease in chinese chronic hepatitis B patients with low viral loads and persistently normal alanine aminotransferase levels[J].J Clin Gastroenterol, 2016, 50 (9) :790-796.
    [20]LI R, LI XY.Association between viral rebound and HBsA g level after entecavir treatment for chronic hepatitis B[J].Chin Hepatol, 2017, 22 (8) :723-726. (in Chinese) 李瑞, 李新艳.慢性乙型肝炎恩替卡韦治疗结束后病毒学反弹与乙型肝炎表面抗原水平的关系[J].肝脏, 2017, 22 (8) :723-726.
    [21]LIU J, LEE MH, BATRLA-UTERMANN R, et al.A predictive scoring system for the seroclearance of HBsA g in HBeA g-seronegative chronic hepatitis B patients with genotype B or C infection[J].J Hepatol, 2013, 58 (5) :853-860.
    [22]CHO JY, SOHN W, SINN DH, et al.Long-term real-world entecavir therapy in treatment-naive hepatitis B patients:base-line hepatitis B virus DNA and hepatitis B surface antigen levels predict virologic response[J].Korean J Intern Med, 2017, 32 (4) :636-646.
    [23]WANG J, SHEN T, HUANG X, et al.Serum hepatitis B virus RNA is encapsidated pregenome RNA that may be associated with persistence of viral infection and rebound.[J].J Hepatol, 2016, 65 (4) :700-710.
    [24]WANG J, SHENG Q, DING Y, et al.HBV RNA virion-like particles produced under nucleos (t) ide analogues treatment are mainly replication-deficient[J].J Hepatol, 2018, 68 (4) :847-849.
    [25]GIERSCH K, ALLWEISS L, VOLZ T, et al.Serum HBV pgRNA as a clinical marker for cccD NA activity[J].J Hepatol, 2017, 66 (2) :460-462.
    [26]WANG J, YU Y, LI G, et al.Relationship between serum HBVRNA levels and intrahepatic viral as well as histologic activity markers in entecavir-treated patients[J].J Hepatol, 2018, 68 (4) :847-849.
    [27]LU FM, WANG J, ZHUANG H.Potential clinical significance of HBV RNA virus-like particle[J].Chin J Hepatol, 2016, 24 (9) :641-642. (in Chinese) 鲁凤民, 王杰, 庄辉.HBV RNA病毒样颗粒的潜在临床意义[J].中华肝脏病杂志, 2016, 24 (9) :641-642.
    [28]TSUGE M, MURAKAMI E, IMAMURA M, et al.Serum HBV RNA and HBeA g are useful markers for the safe discontinuation of nucleotide analogue treatments in chronic hepatitis B patients[J].J Gastroenterol, 2013, 48 (10) :1188-1204.
    [29]WANG J, DU M, HUANG H, et al.Consistent loss of serum HBV RNA might predict the“para-functional cure”of chronic hepatitis B[J].J Hepatol, 2016, 66 (2) :462-463.
    [30]SHIH C, YANG CC, CHOIJILSUREN G, et al.Hepatitis B virus[J].Trends Microbiol, 2018, 26 (4) :386-387.
    [31]MAK LY, WONG DK, CHEUNG KS, et al.Review article:Hepatitis B core-related antigen (HBcrA g) :An emerging marker for chronic hepatitis B virus infection[J].Aliment Pharmacol Ther, 2018, 47 (1) :43-54.
    [32]SUZUKI F, MIYAKOSHI H, KOBAYASHI M, et al.Correlation between serum hepatitis B virus core-related antigen and intrahepatic covalently closed circular DNA in chronic hepatitis B patients[J].J Med Virol, 2009, 81 (1) :27-33.
    [33]CHEN EQ, FENG S, WANG ML, et al.Serum hepatitis B corerelated antigen is a satisfactory surrogate marker of intrahepatic covalently closed circular DNA in chronic hepatitis B[J].Sci Rep, 2017, 7 (1) :173.
    [34]WONG DK, SETO WK, CHEUNG KS, et al.Hepatitis B virus core-related antigen as a surrogate marker for covalently closed circular DNA[J].Liver Int, 2017, 37 (7) :995-1001.
    [35]SURACE L, CAVALLONE D, COLOMBATTO P, et al.Serum hepatitis B core-related antigen is more accurate than hepatitis B surface antigen to identify inactive carriers, regardless of hepatitis B virus genotype[J].Liver Int, 2017, 23 (11) :860-867.
    [36]TADA T, KUMADA T, TOYODA H, et al.Hepatitis B virus core-related antigen levels predict progression to liver cirrhosis in hepatitis B carriers[J].J Gastroenterol Hepatol, 2018, 33 (4) :918-925.
    [37]ANDO Y, ISHIGAMI M, ISHIZU Y, et al.Cumulative incidence and risk factors for the development of hepatocellular carcinoma in patients with chronic hepatitis B who achieved sustained disappearance of viremia by nucleos (t) ide analog treatment[J].Hepatol Res, 2018, 48 (3) :e240-e251.
    [38]SHINKAI N, TANAKA Y, ORITO E, et al.Measurement of hepatitis B virus core-related antigen as predicting factor for relapse after cessation of lamivudine therapy for chronic hepatitis B virus infection[J].Hepatol Res, 2006, 36 (4) :272-276.
    [39]JUNG KS, PARK JY, CHON YE, et al.Clinical outcomes and predictors for relapse after cessation of oral antiviral treatment in chronic hepatitis B patients[J].J Gastroenterol, 2016, 51 (8) :830-839.
    [40]URABE A, IMAMURA M, TSUGE M, et al.The relationship between HBcrA g and HBV reinfection in HBV related post-liver transplantation patients[J].J Gastroenterol, 2017, 52 (3) :366-375.
    [41]HOSAKA T, SUZUKI F, KOBAYASHI M, et al.HBcrA g is a predictor of post-treatment recurrence of hepatocellular carcinoma during antiviral therapy[J].Liver Int, 2010, 30 (10) :1461-1470.
    [42]Drafting Committee for Hepatitis Management G, the Japan Society of H.JSH Guidelines for the Management of Hepatitis B Virus Infection[J].Hepatol Res, 2014, 44:1-58.
    [43]SARIN SK, KUMAR M, LAU GK, et al.Asian-Pacific clinical practice guidelines on the management of hepatitis B:a 2015 update[J].Hepatol Int, 2016, 10 (1) :1-98.
  • 加载中
计量
  • 文章访问数:  2060
  • HTML全文浏览量:  40
  • PDF下载量:  383
  • 被引次数: 0
出版历程
  • 收稿日期:  2018-03-16
  • 出版日期:  2018-06-20
  • 分享
  • 用微信扫码二维码

    分享至好友和朋友圈

目录

    /

    返回文章
    返回