急性乙型肝炎患者前S1抗原与前S1抗体检测的临床意义

目的 分析急性乙型肝炎(acute hepatitis B,AHB)患者前S1 抗原(PreS1Ag)和前S1 抗体(抗PreS1)与HBV DNA转阴、HBeAg 和HBsAg 转阴/血清学转换的关系,初步探讨PreS1Ag/抗PreS1 对AHB 预后的预测价值.方法 纳入15 例AHB患者,动态抽取血清标本,检测...

Clinical significance of PreS1Ag and anti-PreS1 detection in patients with acute hepatitis B

Objective To analyze the correlation between PreS1Ag and anti -PreS1 and the rates of HBV DNA negative conversion and HBeAg/HBsAg negative conversion and seroconversion in patients with acute hepatitis B (AHB), and to investigate the predictive value of PreS1Ag/anti-PreS1 in the prognosis of AHB patients. Methods Fifteen AHB patients were enrolled. Their serum samples were collected at different time points, and dynamic changes of PreS1Ag, anti-PreS1, HBV DNA, HBeAg and HBsAg were tested. Pearson’s correlation coefficient was used to analyze the correlation among the negative conversion time of PreS1Ag, HBV DNA, HBeAg and HBsAg. Results The mean time for HBV DNA, PreS1Ag, HBeAg and HBsAg negative was at 2.50±1.07, 3.00 ±2.61, 3.17 ±1.59 and 6.87 ±5.89 weeks post -treatment, respectively. The patients who had PreS1Ag seroconversion within 3 weeks after the onset of symptoms were classified as rapid -conversion group, and the others were classified as slow -conversion group. The negative conversion time of HBV DNA, HBeAg and HBsAg in rapid -conversion group was shorter than that in slow - conversion group, and the differences in the negative conversion time of HBeAg and HBsAg between the two groups were significant. The correlation analysis of the negative conversion time among PreS1Ag, HBV DNA, HBeAg, and HBsAg in the 15 AHB patients showed that the time of PreS1Ag loss was associated with the negative conversion time of HBV DNA and HBsAg (P<0.05), and the negative conversion time of HBV DNA was associated with that of HBeAg (P<0.05). Conclusions It is found that in AHB patients PreS1Ag and anti-PreS1 are the negative conversion and seroconvension markers appearing the earliest after HBV DNA clearance. Within the first 3 weeks after the onset of symptoms, early PreS1Ag clearance indicates early HBsAg negative conversion or seroconversion, suggesting virus removal and disease recovery. PreS1Ag clearance time is in linear correlation with HBsAg negative conversion time. Therefore, HBsAg negative conversion time can be roughly predicted by observing PreS1Ag clearance time, so as to provide an immunological indicator for the AHB patients who may develop chronicity and require antiviral treatment.