94
￭ S-101 ￭
The prevalence and characteristics of albuminuria in hepatitis B antigen-positive patients in Korea
한양의대 구리병원, 내과학교실
*
임유정, 이은영, 이주학
Background: The prevalence of hepatitis B virus (HBV) infection is estimated to be approximately 3% in Korea. This study aimed to examine the prevalence and characteristics of albuminuria in the HBV surface antigen (HBsAg)-positive Korean population. Methods: We analyzed weighted data obtained from adults aged 19 years or older who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) (2011-2014). A total of 20,024 subjects was analyzed. Results: The prevalence of HBsAg-positivity was 3.8%. there were no significant differences in age (46.3±0.6 vs. 45.8±0.2 yrs, p＝0.404) and body mass index (BMI) (24.0±0.2 vs. 23.8±0.0 kg/m2, p＝0.225) between HBsAg positive and HBV neg- ative subjects. Aspartate aminotransferase (AST, 30.0±1.7 vs. 22.1±0.1 IU/L, p＜0.001) and alanine aminotransferase (ALT, 34.1±3.1 vs. 22.2±0.2 IU/L, p＜0.001) were higher, and total cholesterol (184.2±1.4 vs. 188.6±0.4 mg/dL, p＝0.002) and triglyceride (TG, 119.8±4.6 vs. 138.4±1.1 mg/dL, p
＜0.001) levels were lower in the HBsAg positive subjects. There were no significant differences in the prevalence of albuminuria (5.6 vs. 6.9%, p＝
0.233) and spot urine ACR (22.2±9.0 vs. 17.9±1.1 mcg/mg, p＝0.629) in both groups. The prevalences of hypertension (HTN), diabetes mellitus (DM), metabolic syndrome (MS), and chronic kidney disease (CKD) were similar between the both groups, and age- and gender- adjusted logistic regressions revealed that HBsAg positivity was not associated with HTN (odds ratio [OR], 0.970; 95% confidence interval [CI], 0.789-1.193; p＝0.774), DM(OR, 0.874; 95% CI, 0.627-1.218; p＝0.427), MS (OR, 0.955; 95% CI, 0.753-1.211; p＝0.706), or CKD (OR, 0.820; 95% CI, 0.586-1.148; p＝0.247). In ad- ditional multivariate logistic regression analyses adjusted by gender, age, HTN, DM, AST, ALT, total cholesterol, triglyceride, HBsAg-positivity was not associated with albuminuria (OR, 0.816; 95% CI, 0.567-1.176; p＝0.275), or low estimated glomerular filtration rate (eGFR) (OR, 1.164; 95% CI, 0.624-2.171; p＝0.633).
￭ S-102 ￭
Dysfunctional HBV-specific T cell response in patients with immune tolerant phase
가톨릭대학교 내과학교실, 간연구소
성필수*, 장정원, 배시현, 윤승규
Aims: Chronic hepatitis B virus (HBV) infection is typically established neonatally and progresses through different phases: immune tolerant (IT), im- mune clearance (IC), inactive carrier (IC), and HBeAg-negative chronic hepatitis. In this study, we aimed to characterize HBV-specific T cell response in the patients of chronic HBV infection in Korea. Methods: We formed CHB cohort with 20 immune tolerant, 20 immune clearance, and 30 patients with antiviral treatment. After isolation of peripheral blood mononuclear cells (PBMCs), we performed Enzyme-Linked ImmunoSpot (ELISPOT) assay di- rectly ex vivo. Moreover, we performed pentamer staining assay to identify HCV-specific CD8+ T cells and examined the expression of PD-1 and CD127 in pentamer-positive cells. Results: Direct ex vivo ELISPOT showed HBV-specific T cell dysfunction in both IT and IC phase patients.
However, some patients with current antiviral therapy or recent discontinuation of antiviral therapy showed modest ex vivo ELISPOT response.
Interestingly, short-term culture of PBMC also showed that some IT patients can have HBV-specific CD8+ T cells with the ability to produce IFN-γ.
Pentamer staining showed HBV-specific T cells are present in IT phase of CHB patients. Conclusion: Collectively, our data shows HBV-specific T-cells are defective in IT phase of Korean patients with chronic HBV infection, and antiviral therapy may restore IFN-γ-producing function of these cells.
Variables IT (n=14) IA (n=17) AT (n=12)
Age (years), median (range) 37 (25-53) 40 (25-67) 48 (25-74)
Male sex, n (%) 7 (47) 12 (71) 8 (67)
HBeAg (+) 14 (100) 11 (65) 1 (8)
Anti-Hbe (+) 0 (0) 6 (35) 8 (67)
Median HBV DNA level
(log copies/mL) 8.37 (5.48-9.53) 7.97 (6.01-9.53) 2.04 (LOD-3.17) ALT (U/L), median (range) 31 (14-37) 209 (52-4700) 24 (15-43) Antiviral therapy, n (%)
None Adefovir Entecavir Tenofovir
16 (100) 0 (0) 0 (0) 0 (0)
17 (100) 0 (0) 0 (0) 0 (0)
0 (0) 1 (8) 7 (58) 4 (33)
