AASLD2012:急性B肝炎 高水平的乙肝病毒导致慢性感染

StephenW

*CONTROL ID: *1421612

*PRESENTATION TYPE: *Oral or Poster

*CURRENT CATEGORY: *Hepatitis B

*CURRENT DESCRIPTORS: *I01. Patient-centered, Natural History and Effectiveness Research

*TITLE: *High levels of HBV after the onset lead to chronic infection in patients with acute hepatitis B

*AUTHORS (FIRST NAME, LAST NAME): *_Hiroshi Yotsuyanagi_^1 , Kiyoaki Ito^2 , Norie Yamada^4, 3 , Hideaki Takahashi^3 , Chiaki Okuse^3 , Kiyomi Yasuda^4 , Michihiro Suzuki^3 , Kyoji Moriya^1 , Masashi Mizokami^2 , Yuzo Miyakawa^5 , Kazuhiko Koike^1

*Institutional Author(s): *

*INSTITUTIONS (ALL): *1. Internal Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
2. National Center for Global Health and Medicine, Ichikawa, Japan.
3. Gastroenterology and Hepatology, Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
4. Internal Medicine, Center for Liver Diseases, Kiyokawa Hospital, Tokyo, Japan.
5. Miyakawa Memorial Research Foundation, Tokyo, Japan.

*ABSTRACT BODY: *BACKGROUND & AIMS: Some patients with acute hepatitis B virus (HBV) infection develop chronic infection. However, the method for identifying them has not been established. METHODS: We followed 215 Japanese patients with acute HBV infection until the clearance of hepatitis B surface antigen (HBsAg) or the development of chronic infection. Levels of HBsAg and HBV DNA were serially monitored. RESULTS: Of the 215 patients, 113 (52.5%) possessed HBV genotype A, 26 (12.0%) genotype B, and 73 (34.0%) genotype C. Twenty-one of the 215 (9.8%) developed chronic infection, with the persistence of HBsAg for > 6 months. The rate of chronicity of genotype A, B, and C was 12.4%, 3.8%, and 8.2%. Of the 21 patients, only six (2.8%) patients, including five with genotype A, failed to clear HBsAg within 12 months. Levels of HBsAg at 12 weeks and HBV DNA at 4 weeks from the onset were useful for distinguishing the patients who became chronic from those who did not (P < . 001 and P < . 001, respectively). Likewise, the levels of HBsAg at 12 weeks and HBV DNA at 8 weeks were useful for discriminating between the patients who lost HBsAg within 12 months from the onset and those who did not (P < .01 and P < .05, respectively). CONCLUSIONS: In acute HBV infection, genotype A is associated with the development of chronic infection (> 6 months), including acute prolonged cases (> 6--12 months). In patients with genotype A, only those who fail to clear HBV within 12 months from the onset may really develop chronic infection

StephenW

背景与目的：有些患者在急性B型肝炎病毒（HBV）感染发展成慢性感染。然而，该方法用于识别它们尚未建立。方法：我们遵循215例日本患者急性HBV感染B型肝炎表面抗原（HBsAg）或慢性感染的发展，直到通关。 HBsAg和HBV DNA水平进行连续监测。结果：在215例患者中，113例（52.5％）拥有HBV基因型A，26 B型（12.0％），和73（34.0％），C型25-215（9.8％）发展为慢性感染，乙型肝炎表面抗原（HBsAg）> 6个月的持久性。基因型A，B，和C的慢性化率是12.4％，3.8％和8.2％。在21例患者中，只有6例（2.8％），其中包括5个基因型，在12个月内未能清除乙肝表面抗原。用于区分病人从那些谁没有（P <0.001和P <0.001，分别）为慢性乙肝表面抗原在发病4周，12周，HBV DNA水平。同样，在第8周时乙肝表面抗原在12周，HBV DNA水平区分谁失去了HBsAg的12个月内从一开始，这些患者是有用的，谁没有（P <0.01和P <0.05）。结论：在急性HBV感染者中，A基因型与发展的慢性感染（> 6个月），包括急性长时间的情况下（> 6  -  12个月）。在A基因型的患者中，只有那些无法清除HBV的12个月内从一开始可能真的发展成慢性感染