目的探讨HBs Ag酶联免疫试剂检测试管血和导管血S/CO的差异性。方法厦门新创HBs Ag ELISA试剂检测2015年1月1日至2015年4月30日无偿献血者标本17967例,对初次反应性标本用原试管和血袋导管血分别进行双孔复试。结果检测17967例标本,共...目的探讨HBs Ag酶联免疫试剂检测试管血和导管血S/CO的差异性。方法厦门新创HBs Ag ELISA试剂检测2015年1月1日至2015年4月30日无偿献血者标本17967例,对初次反应性标本用原试管和血袋导管血分别进行双孔复试。结果检测17967例标本,共检测阳性标本143例,阳性率为0.8%。试管血与导管血S/CO≥28有56例,10≤S/CO<28间的有40例,1.5≤S/CO<10的有36例,0.8≤S/CO<1.5的有11例。采用T检验,10≤S/CO<28间的40例和1.5≤S/CO<10的36例,0.8≤S/CO<1.5的11例,导管血S/CO均明显低于试管血。结论除强阳性标本外,导管血S/CO明显低于试管血,为保证血液结果的准确性,对初次反应性处于灰区的标本不适于单独使用导管血进行复查。展开更多
Objective To explore the predictive value of baseline HBs Ag level and early response for HBs Ag loss in patients with HBe Ag-positive chronic hepatitis B during pegylated interferon alpha-2a treatment. Methods A tota...Objective To explore the predictive value of baseline HBs Ag level and early response for HBs Ag loss in patients with HBe Ag-positive chronic hepatitis B during pegylated interferon alpha-2a treatment. Methods A total of 121 patients with HBe Ag-positive chronic hepatitis B who achieved HBs Ag loss were enrolled; all patients were treated with PEG-IFNα-2a 180 μg/week. Serum HBV DNA and serological indicators （HBs Ag, anti-HBs, HBe Ag, and anti-HBe） were determined before and every 3 months during treatment. Results The median treatment time for HBs Ag loss was 84 weeks （7-273 weeks）, and 74.38% （90 cases） of the patients needed extended treatment （〉 48 weeks）. The correlation between baseline HBs Ag levels and the treatment time of HBs Ag loss was significant （B = 14.465, t = 2.342, P = 0.021）. Baseline HBs Ag levels together with the decline range of HBs Ag at 24 weeks significantly correlated with the treatment time of HBs Ag loss （B = 29.862, t = 4.890, P = 0.000 and B = 27.993, t = 27.993, P = 0.005）. Conclusion Baseline HBs Ag levels and extended therapy are critical steps toward HBs Ag loss. Baseline HBs Ag levels together with early response determined the treatment time of HBs Ag loss in patients with HBe Ag-positive chronic hepatitis B during pegylated interferon alpha-2a treatment.展开更多
AIM To investigate the characteristic features of hepatitis B surface antigen(HBs Ag) seroclearance among Korean hepatitis B virus(HBV) carriers.METHODS Carriers with HBs Ag seroclearance were selected by analyzing lo...AIM To investigate the characteristic features of hepatitis B surface antigen(HBs Ag) seroclearance among Korean hepatitis B virus(HBV) carriers.METHODS Carriers with HBs Ag seroclearance were selected by analyzing longitudinal data collected from 2003 to 2015. The period of time from enrollment to the negative conversion of HBs Ag(HBs Ag-NC) was compared by stratifying various factors, including age, sex, hepatitis B e antigen(HBe Ag), HBV DNA, sequential changes in the signal-to-cutoff ratio of HBs Ag(HBs Ag-SCR), as measured by qualitative HBs Ag assay, and chronic liver disease on ultrasonography(US-CLD). Quantification of HBV DNA and HBs Ag(HBs Ag-QNT) in the serum was performed by commercial assay.RESULTS Among the 1919 carriers, 90(4.7%) exhibited HBs AgNC at 6.2 ± 3.6 years after registration, with no differences observed among the different age groups. Among these carriers, the percentages of those with asymptomatic liver cirrhosis(LC) and hepatocellular carcinoma(HCC) at registration were 31% and 7.8%, respectively. The frequency of HBs Ag-NC significantly differed according to the HBV DNA titer and US-CLD. HBe Ag influenced HBs Ag-NC in the 40-50 and 50-60 year age groups. HBs Ag-SCR < 1000 was correlated with an HBs Ag-QNT < 200 IU/m L. A gradual decrease in the HBs Ag-SCR to < 1000 predicted HBs Ag-NC. Six patients developed HCC after registration, including two before and four after HBs Ag-NC. The rate at which the patients developed new HCC after HBs Ag seroclearance was 4.8%. LC with excessive drinking and vertical infection were found to be risk factors for HCC in the HBs Ag-NC group.CONCLUSION HCC surveillance should be continued after HBs Ag seroclearance. An HBs Ag-SCR < 1000 and its decrease in sequential testing are worth noting as predictive markers of HBs Ag loss.展开更多
Objective: Hepatocellular carcinoma(HCC) development among hepatitis B surface antigen(HBs Ag) carriers shows gender disparity, influenced by underlying liver diseases that display variations in laboratory tests. We a...Objective: Hepatocellular carcinoma(HCC) development among hepatitis B surface antigen(HBs Ag) carriers shows gender disparity, influenced by underlying liver diseases that display variations in laboratory tests. We aimed to construct a risk-stratified HCC prediction model for HBs Ag-positive male adults.Methods: HBs Ag-positive males of 35-69 years old(N=6,153) were included from a multi-center populationbased liver cancer screening study. Randomly, three centers were set as training, the other three centers as validation. Within 2 years since initiation, we administrated at least two rounds of HCC screening using Bultrasonography and α-fetoprotein(AFP). We used logistic regression models to determine potential risk factors,built and examined the operating characteristics of a point-based algorithm for HCC risk prediction.Results: With 2 years of follow-up, 302 HCC cases were diagnosed. A male-ABCD algorithm was constructed including participant's age, blood levels of GGT(γ-glutamyl-transpeptidase), counts of platelets, white cells,concentration of DCP(des-γ-carboxy-prothrombin) and AFP, with scores ranging from 0 to 18.3. The area under receiver operating characteristic was 0.91(0.90-0.93), larger than existing models. At 1.5 points of risk score,26.10% of the participants in training cohort and 14.94% in validation cohort were recognized at low risk, with sensitivity of identifying HCC remained 100%. At 2.5 points, 46.51% of the participants in training cohort and 33.68% in validation cohort were recognized at low risk with 99.06% and 97.78% of sensitivity, respectively. At 4.5 points, only 20.86% of participants in training cohort and 23.73% in validation cohort were recognized at high risk,with positive prediction value of 22.85% and 12.35%, respectively.Conclusions: Male-ABCD algorithm identified individual's risk for HCC occurrence within short term for their HCC precision surveillance.展开更多
文摘目的探讨HBs Ag酶联免疫试剂检测试管血和导管血S/CO的差异性。方法厦门新创HBs Ag ELISA试剂检测2015年1月1日至2015年4月30日无偿献血者标本17967例,对初次反应性标本用原试管和血袋导管血分别进行双孔复试。结果检测17967例标本,共检测阳性标本143例,阳性率为0.8%。试管血与导管血S/CO≥28有56例,10≤S/CO<28间的有40例,1.5≤S/CO<10的有36例,0.8≤S/CO<1.5的有11例。采用T检验,10≤S/CO<28间的40例和1.5≤S/CO<10的36例,0.8≤S/CO<1.5的11例,导管血S/CO均明显低于试管血。结论除强阳性标本外,导管血S/CO明显低于试管血,为保证血液结果的准确性,对初次反应性处于灰区的标本不适于单独使用导管血进行复查。
基金supported by Beijing Science and Technology Commission(No.D121100003912001)Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding,Support(No.ZY201402)
文摘Objective To explore the predictive value of baseline HBs Ag level and early response for HBs Ag loss in patients with HBe Ag-positive chronic hepatitis B during pegylated interferon alpha-2a treatment. Methods A total of 121 patients with HBe Ag-positive chronic hepatitis B who achieved HBs Ag loss were enrolled; all patients were treated with PEG-IFNα-2a 180 μg/week. Serum HBV DNA and serological indicators （HBs Ag, anti-HBs, HBe Ag, and anti-HBe） were determined before and every 3 months during treatment. Results The median treatment time for HBs Ag loss was 84 weeks （7-273 weeks）, and 74.38% （90 cases） of the patients needed extended treatment （〉 48 weeks）. The correlation between baseline HBs Ag levels and the treatment time of HBs Ag loss was significant （B = 14.465, t = 2.342, P = 0.021）. Baseline HBs Ag levels together with the decline range of HBs Ag at 24 weeks significantly correlated with the treatment time of HBs Ag loss （B = 29.862, t = 4.890, P = 0.000 and B = 27.993, t = 27.993, P = 0.005）. Conclusion Baseline HBs Ag levels and extended therapy are critical steps toward HBs Ag loss. Baseline HBs Ag levels together with early response determined the treatment time of HBs Ag loss in patients with HBe Ag-positive chronic hepatitis B during pegylated interferon alpha-2a treatment.
文摘AIM To investigate the characteristic features of hepatitis B surface antigen(HBs Ag) seroclearance among Korean hepatitis B virus(HBV) carriers.METHODS Carriers with HBs Ag seroclearance were selected by analyzing longitudinal data collected from 2003 to 2015. The period of time from enrollment to the negative conversion of HBs Ag(HBs Ag-NC) was compared by stratifying various factors, including age, sex, hepatitis B e antigen(HBe Ag), HBV DNA, sequential changes in the signal-to-cutoff ratio of HBs Ag(HBs Ag-SCR), as measured by qualitative HBs Ag assay, and chronic liver disease on ultrasonography(US-CLD). Quantification of HBV DNA and HBs Ag(HBs Ag-QNT) in the serum was performed by commercial assay.RESULTS Among the 1919 carriers, 90(4.7%) exhibited HBs AgNC at 6.2 ± 3.6 years after registration, with no differences observed among the different age groups. Among these carriers, the percentages of those with asymptomatic liver cirrhosis(LC) and hepatocellular carcinoma(HCC) at registration were 31% and 7.8%, respectively. The frequency of HBs Ag-NC significantly differed according to the HBV DNA titer and US-CLD. HBe Ag influenced HBs Ag-NC in the 40-50 and 50-60 year age groups. HBs Ag-SCR < 1000 was correlated with an HBs Ag-QNT < 200 IU/m L. A gradual decrease in the HBs Ag-SCR to < 1000 predicted HBs Ag-NC. Six patients developed HCC after registration, including two before and four after HBs Ag-NC. The rate at which the patients developed new HCC after HBs Ag seroclearance was 4.8%. LC with excessive drinking and vertical infection were found to be risk factors for HCC in the HBs Ag-NC group.CONCLUSION HCC surveillance should be continued after HBs Ag seroclearance. An HBs Ag-SCR < 1000 and its decrease in sequential testing are worth noting as predictive markers of HBs Ag loss.
基金supported by State Key Projects Specialized on Infectious Diseases (No. 2017ZX10201201-006)Key research projects for precision medicine (No. 2017YFC0908103)+1 种基金Innovation Fund for Medical Sciences of Chinese Academy of Medical Sciences (CIFMS, No. 2019-I2M-2-004, 2016-I2M-1-007, 2019-I2M-1-003)National Natural Science Foundation Fund (No. 81972628, No. 81974492)。
文摘Objective: Hepatocellular carcinoma(HCC) development among hepatitis B surface antigen(HBs Ag) carriers shows gender disparity, influenced by underlying liver diseases that display variations in laboratory tests. We aimed to construct a risk-stratified HCC prediction model for HBs Ag-positive male adults.Methods: HBs Ag-positive males of 35-69 years old(N=6,153) were included from a multi-center populationbased liver cancer screening study. Randomly, three centers were set as training, the other three centers as validation. Within 2 years since initiation, we administrated at least two rounds of HCC screening using Bultrasonography and α-fetoprotein(AFP). We used logistic regression models to determine potential risk factors,built and examined the operating characteristics of a point-based algorithm for HCC risk prediction.Results: With 2 years of follow-up, 302 HCC cases were diagnosed. A male-ABCD algorithm was constructed including participant's age, blood levels of GGT(γ-glutamyl-transpeptidase), counts of platelets, white cells,concentration of DCP(des-γ-carboxy-prothrombin) and AFP, with scores ranging from 0 to 18.3. The area under receiver operating characteristic was 0.91(0.90-0.93), larger than existing models. At 1.5 points of risk score,26.10% of the participants in training cohort and 14.94% in validation cohort were recognized at low risk, with sensitivity of identifying HCC remained 100%. At 2.5 points, 46.51% of the participants in training cohort and 33.68% in validation cohort were recognized at low risk with 99.06% and 97.78% of sensitivity, respectively. At 4.5 points, only 20.86% of participants in training cohort and 23.73% in validation cohort were recognized at high risk,with positive prediction value of 22.85% and 12.35%, respectively.Conclusions: Male-ABCD algorithm identified individual's risk for HCC occurrence within short term for their HCC precision surveillance.
