在慢性乙型肝炎治疗过程中HBsAg水平与HBV DNA病毒复制的相关性分析

目的： 病毒载量的测定常被用来诊断和监测慢性乙型肝炎的疗效。文献报道采用全自动微粒子化学发光免疫反应测定HBsAg水平可作为替代标记。本研究旨在进一步分析慢性乙型肝炎治疗过程中血清HBsAg水平和HBV DNA水平的相关性。方法：本研究选取47例慢性乙型肝炎的患者［男性35人，女性12人，平均年龄(35±8)岁］。聚乙二醇化干扰素α-2a单一治疗患者（18例）、聚乙二醇化干扰素α-2a +拉米夫定联合治疗患者（14例）、拉米夫定单一治疗患者（15例）治疗48周并留取0、4、8、24、48、72周的血清。用TaqMan PCR测定HBV DNA水平，全自动微粒子化学发光免疫反应测定HBsAg水平。结果：18例聚乙二醇化干扰素α-2a单一治疗的患者和14例聚乙二醇化干扰素α-2a +拉米夫定联合治疗的患者可观察到HBsAg滴度随HBV DNA复制水平的一致变化，呈显著相关（r=0.83，P<0.01）。而在15例拉米夫定单一治疗的患者则未观察到HBsAg滴度随HBV DNA复制水平一致的变化趋势，但无相关性。聚乙二醇化干扰素α-2a单一治疗、聚乙二醇化干扰素α-2a+拉米夫定联合治疗的患者HBsAg水平中位数下降幅度均明显优于拉米夫定单一治疗的患者（P<0.05）。结论：在以干扰素为基础的慢性乙型肝炎治疗期间，血清HBsAg水平与HBV DNA 水平显著相关，动态HBsAg定量监测对治疗有一定的指导意义，可作为监测HBV疗效的替代标记。

Correlation between HBsAg level and HBV DNA titer during chronic hepatitis B treatment

AIM: Viral load is widely used as an indicator for the diagnosis and monitoring the treatment efficacy of chronic hepatitis B (CHB). Previous studies suggested that the quantity of hepatitis B surface antigen (HBsAg) in serum could be a surrogate marker of serum hepatitis B virus (HBV) DNA level. In this study, we aimed to investigate whether HBsAg level correlates with HBV DNA titer during CHB treatment. METHODS: Sera were collected from 47 CHB patients ［35 male, 12 female, mean age: (35±8) years］ treated for 48 weeks with a monotherapy (pegylated interferon alpha-2a, 18 patients; lamivudine, 15 patients) or a combination therapy (pegylated interferon alpha-2a and lamivudine, 14 patients). Serum samples were obtained at week 0 (just before the treatment), 4, 8, 24, 48 and week 72 (24 weeks after the treatment). HBV DNA was measured with real-time polymerase chain reaction (PCR). HBsAg was quantified with an automated chemiluminescent microparticle immunoassay. RESULTS: The titer of HBsAg correlated with the HBV DNA level in the 18 patients with monotherapy of pegylated interferon alpha-2a and the 14 patients with combination therapy (pegylated interferon alpha-2a and lamivudine). The significant correlation (canonical correlation=0.83) was found. However, no correlation in 15 patients with the monotherapy of lamivudine was observed. CONCLUSION: HBsAg titer correlates with HBV DNA level in CHB patients during the treatment with interferon or interferon and lamivudine, which can be a surrogate marker for monitoring the treatment efficacy.