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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 11
Nov.  2013
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Article Contents

Predictive value of HBcrAg for lamivudine resistance in patients with chronic hepatitis B

DOI: 10.3969/j.issn.1001-5256.2013.11.005
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  • Received Date: 2013-01-28
  • Published Date: 2013-11-20
  • Objective To evaluate the predictive value of hepatitis B virus ( HBV) core- related antigen ( HBcrAg) for the lamivudine ( LAM) resistance in patients with chronic hepatitis B. Methods Forty- three patients with previously untreated chronic hepatitis B who were treated in the inpatient department and outpatient department from January 2009 to December 2011 were enrolled. These patients received treatment with LAM for at least 6 months and were then followed up for at least 6 months. They were divided into resistance group ( n= 21) and non- resistance group ( n = 22) according to the HBV DNA sequencing results during follow up. ALT, HBsAg, HBeAg, HBcrAg, and HBV DNA levels at different time points were measured. Comparison of continuous data between the two groups was made by independent- samples t test, and Mann- Whitney U test was used if heterogeneity of variance was identified; categorical data were analyzed by chi- square test; correlations were determined by Spearman analysis; the influential factors were determined by logistic regression analysis. Results Before treatment with LAM, there was a significant positive correlation between the HBcrAg and HBV DNA levels in peripheral blood ( Spearman correlation coefficient r = 0. 863, P < 0. 001) . After the initiation of LAM therapy, both HBcrAg and HBV DNA levels decreased, and the decrease in HBcrAg level was significantly slower and smaller than that in HBV DNA level. The logistic regression analysis showed that HBcrAg level at the end of follow- up might be an influential factor for LAM resistance ( P < 0. 01) . HBcrAg had a high predictive value for LAM resistance, with an area under the ROC curve of 0. 872 ( P < 0. 001) . Conclusion There is a significant positive correlation between HBcrAg and HBV DNA levels in peripheral blood before LAM administration, and the HBcrAg level at the end of follow-up has a high predictive value for LAM resistance in patients with chronic hepatitis B.

     

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