血清BAFF预测聚乙二醇干扰素-α治疗非活动性HBsAg携带者临床治愈的效能分析  

Serum B-cell activating factor levels in predicting antiviral response of pegylated interferon alpha in inactive HBsAg carriers

作　　者：吴凤萍[1] 崔丹丹 王怡恺 李梅[1] 刘晨瑞 南希 贾晓黎[1] 党双锁[1] Wu Fengping;Cui Dandan;Wang Yikai(Department of Infectious Diseases,Second Affiliated Hospital,Xi’an Jiaotong University,Xi’an 710004,Shaanxi Province,China)

机构地区：[1]西安交通大学第二附属医院感染病科,西安市710004

出　　处：《实用肝脏病杂志》2022年第6期780-783,共4页Journal of Practical Hepatology

基　　金：陕西省重点研发计划社会发展领域一般项目(编号:2020SF-297)。

摘　　要：目的探讨血清B细胞活化因子(BAFF)预测聚乙二醇干扰素-α(Peg-IFN-α)治疗非活动性HBsAg携带者(IHCs)临床治愈的效能。方法2018年1月~2020年8月我院诊治的IHCs 54例,给予Peg-IFN-α治疗48 w,再随访24 w。采用ELISA法检测血清BAFF,应用Logistic回归分析影响临床治愈的因素,应用受试者工作特征曲线(ROC)及其曲线下面积(AUC)评价血清BAFF预测临床治愈的效能。结果在72 w末,24例(44.4%)患者获得临床治愈,30例未获得临床治愈;治愈组与未治愈组基线血清BAFF水平分别为(670.9±105.9)pg/mL和(612.7±183.8)pg/mL,差异无统计学意义(P>0.05);在治疗12 w和24 w时,治愈组血清BAFF水平分别为(805.8±197.6)pg/mL和(895.3±227.4)pg/mL,显著高于未治愈组【分别为(675.3±190.8)pg/mL和(724.4±218.0)pg/mL,P均<0.05】;多因素Logistic回归分析显示基线HBsAg定量、HBV DNA<20 IU/mL、治疗12 w和24 w时血清BAFF水平是影响临床治愈的独立因素;ROC分析显示,以Peg-IFN-α治疗12 w时血清BAFF水平大于704.3 pg/mL为截断点,其预测治疗应答的AUC=0.722,敏感度为79.2%,特异度为66.7%,以24 w时血清BAFF水平大于741.9 pg/mL为截断点,其预测治疗应答的AUC=0.725,敏感度为75.0%,特异度为70.0%。结论应用Peg-IFN-α治疗IHCs可获得约40%的应答率,在治疗过程中监测血清BAFF水平逐渐升高的患者可能获得满意的治疗结果。Objective The aim of this study was to investigate serum B-cell activating factor(BAFF)levels in predicting antiviral response of pegylated interferon alpha(Peg-IFN-α)in inactive HBsAg carriers(IHCs).Methods 54 IHCs were recruited in our hospital between January 2018 and August 2020,and all were treated with Peg-IFN-αfor 48 weeks and followed-up for 24 weeks.Serum BAFF levels were measured by ELISA.The Logistic regression analysis was applied to analyze the factors affecting antiviral response,and the area under the receiver-operating characteristic curve(AUC)were applied to evaluate the performance of serum BAFF levels in predicting antiviral response.Results At the end of 72 weeks,the complete response(CR)was obtained in 24 cases(44.4%),and were not obtained in 30 cases(55.6%);there was no significant difference as respect to baseline serum BAFF levels[(670.9±105.9)pg/mL vs.(612.7±183.8)pg/mL,P>0.05]between the two groups;at the end of 12 weeks and 24 weeks,serum BAFF levels in responders were(805.8±197.6)pg/mL and(895.3±227.4)pg/mL,both significantly higher than[(675.3±190.8)pg/mL and(724.4±218.0)pg/mL,respectively,P<0.05]in non-responders;the multivariate Logistic regression analysis showed that baseline serum HBsAg,HBV DNA<20 IU/mL,serum BAFF levels at week 12 and week 24 were the independent factors impacting the antiviral response;the ROC analysis demonstrated that the AUC=0.722,with the sensitivity(Se)of 79.2%and specificity(Sp)of 66.7%,when serum BAFF level greater than 704.3 pg/mL at week 12 was set as the cut-off-value,and the AUC=0.725,with Se of 75.0%and Sp of 70.0%,when serum BAFF level greater than 741.9 p g/mL at week 24 was set as the cut-off-value in predicting antiviral response in patients receiving Peg-IFN-αtreatment.Conclusion The CR is nearly 40%in IHCs receiving Peg-IFN-αtreatment,and the surveillance of serum BAFF levels might guide the regimen going or stopping.

关 键 词：慢性乙型肝炎 非活动性乙型肝炎病毒表面抗原携带者 聚乙二醇干扰素-α B细胞活化因子 治疗应答 

分 类 号：R512.62[医药卫生—内科学]