Comparison of the Clinical Features of Hepatitis A between HBsAg-Positive and HB

StephenW

Gut Liver. 2011 Dec;5(4):500-5. Epub 2011 Nov 21.
Comparison of the Clinical Features of Hepatitis A between HBsAg-Positive
and HBsAg-Negative Patients. Source:
http://www.ncbi.nlm.nih.gov/pubmed/22195250 Kim KM, Eo SJ, Gwak GY, Choi
MS, Lee JH, Koh KC, Yoo BC, Paik SW. SourceDivision of Gastroenterology,
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea.

Abstract
BACKGROUND/AIMS: The notion that acute hepatitis A superimposed on chronic
hepatitis B infection leads to a worse outcome than acute hepatitis A alone
remains controversial. The aim of this study was to determine the
influence of the presence of hepatitis B surface antigen (HBsAg) on the
severity of acute hepatitis A.

METHODS: We retrospectively analyzed 449 patients hospitalized for acute
hepatitis A from January 2000 to February 2010 and compared clinical
outcomes based on the presence of HBsAg.

RESULTS: Of the 449 patients, 30 patients were in the HBsAg-positive group
and 419 in the HBsAg-negative group. The HBsAg-positive group was older
than the HBsAg-negative group (36.1±8.3 vs 31.8±8.5 years, p=0.004);
however, other baseline characteristics were similar between the 2 groups.
Mean peak values of prothrombin time, serum total bilirubin, and serum
creatinine at admission were significantly higher in the HBsAg-positive
group. When comparing clinical outcomes between the 2 groups,
gastrointestinal bleeding, acute renal failure, and acute liver failure
were more frequently observed in the HBsAg-positive group. In particular,
the incidence of acute liver failure was approximately 9-fold higher in the
HBsAg-positive group than in the HBsAg-negative group (23.3% vs 3.3%; odds
ratio [OR], 8.80; p<0.001). Multivariate analysis showed that HBsAg (OR,
7.43; 95% confidence interval [CI], 2.56 to 21.57) and age (OR, 1.07; 95%
CI, 1.02 to 1.13) were independent risk factors for the occurrence of acute
liver failure.

CONCLUSIONS: In patients with chronic hepatitis B infection, acute
hepatitis A is associated with more severe clinical outcomes, including
acute liver failure, compared with patients with acute hepatitis A alone.

StephenW

肠肝。 2011月; 5（4）:500 - 5。 EPUB 2011年11月21。
对HBsAg阳性的肝炎一个临床特点比较
和HBsAg阴性的患者。来源：
EO SJ，郭庚寅，财金知识，http://www.ncbi.nlm.nih.gov/pubmed/22195250
MS，李津海，岛架KC，柳公元前，白SW。 SourceDivision消化内科，
三星医疗中心，韩国成均馆大学医学院，首尔，
韩国。

摘要
背景/目的：急性肝炎对慢性叠加的概念
乙肝病毒感染导致更坏的结果比急性肝炎一个单独
仍存在争议。本研究的目的是确定
影响上存在的乙肝表面抗原（HBsAg）
严重性急性甲型肝炎

方法：回顾性分析了449对急性病人住院
A型肝炎从2000年1月至2010年2月相比，临床
成果的基础上存在的HBsAg。

结果：449例患者中，30例患者中HBsAg阳性组
在HBsAg阴性组419。 HBsAg阳性组年龄大了
比HBsAg阴性组（36.1 ± 8.3比31.8 ± 8.5年，P = 0.004）;
然而，其他2组之间的基线特征相似。
平均峰值，凝血酶原时间，血清总胆红素，血清
入院时肌酐均显着高于HBsAg阳性
组。当比较2组之间的临床结果，
消化道出血，急性肾功能衰竭，急性肝功能衰竭
更频繁地观察到，在HBsAg阳性组。特别是，
在急性肝功能衰竭的发病率约9倍以上
HBsAg阳性组比HBsAg阴性组（23.3％和3.3％;赔率
比[OR]，8.80; P <0.001）。多因素分析显示，乙肝表面抗原（或，
7.43; 95％信心区间[CI]，2.56至21.57）和年龄（OR，1.07; 95％
CI，1.02至1.13），急性发生的独立危险因素
肝功能衰竭。

结论：在慢性乙型肝炎患者中，急性
更严重的临床结果，包括与A型肝炎
急性肝功能衰竭，与一个单独的急性肝炎患者相比。