特性和预测HBeAg阴性肝炎在慢性乙型肝炎患者的血清学转换后

StephenW

Source: Hepatol Res  |  Posted 5 days ago
Characteristics and prediction of HBeAg-negative hepatitis following seroconversion in patients with chronic hepatitis B;

Morita S, Matsumoto A, Umemura T, Shibata S, Kamijo N, Ichikawa Y, Kimura T, Joshita S, Komatsu M, Yoshizawa K, Tanaka E; Hepatology Research (Jul 2013)

   

AIM We analyzed the characteristics of alanine aminotransferase (ALT) abnormality after achieving hepatitis B e antigen (HBeAg) seroconversion (SC) and other factors associated with the occurrence of HBeAg-negative hepatitis.

METHODS We followed 36 patients with chronic hepatitis B from 3 years prior to at least 3 years after SC (mean: 11.6 years) and examined ALT, HBV DNA, HB surface antigen, HB core-related antigen (HBcrAg) levels and mutations related to HBeAg SC.

RESULTS ALT normalization (<31 IU/L for at least 1 year) was primarily observed until 2 years following SC, after which it became more infrequent. We next divided patients into abnormal (≥31 IU/L, n=20) and normal (<31 IU/L, n=16) groups based on integrated ALT level after the time point of 2 years from SC, and considered the former group as having HBeAg-negative hepatitis in the present study. Although changes in median levels of ALT and HBcrAg differed significantly between the groups, multivariate analysis showed ALT normalization within 2 years after SC to be the only significant determining factor for this disease (P = 0.001). We then assessed the 19 patients whose ALT was normal at 2 years following SC, 4 of whom developed HBeAg-negative hepatitis. Increased levels of HBV DNA (P = 0.037) and HBcrAg (P = 0.033) were significant factors of potential relevance.

CONCLUSIONS ALT abnormality after 2 years of SC may be evaluated as HBeAg-negative hepatitis. ALT, HBV DNA, and HBcrAg levels may be useful in predicting the outcome of patients who achieve HBeAg SC.

StephenW

AIM实现乙肝e抗原（HBeAg）血清学转换（SC）和其他相关因素发生HBeAg阴性肝炎后丙氨酸转氨酶（ALT）异常的特点进行了分析。

我们遵循的方法从3岁前至少3年后，南卡罗来纳州（平均11.6岁）和年审ALT，HBV-DNA，乙肝表面抗原，乙肝核心抗原水平（HBcrAg）和突变相关的慢性乙型肝炎36例大三阳SC。

结果ALT复常（<31 IU / L，至少1年）主要是观察，直到2年后，SC，之后它变得更加罕见。接下来，我们将患者进入异常（≥31 IU/ L，N= 20）和正常组（<31 IU/ L，N=16）的基础上集成的ALT水平从SC2年后的时间点，并认为前者在本研究中，HBeAg阴性肝炎组。虽然中位数水平ALT和HBcrAg的变化组之间的显着差异，多因素分析显示ALT正常化，SC后两年内是唯一重要的决定因素对本病（P = 0.001）。然后，我们评估了19例患者，其在2岁以下，其中4 SC开发HBeAg阴性肝炎ALT为正常。 HBV DNA（P=0.037）和HBcrAg（P = 0.033）水平的提高是显着的潜在相关因素。

HBeAg阴性肝炎结论ALT异常，可能被评估为2年后的SC。 ALT，HBV DNA，和HBcrAg水平可能是有用的预测结果患者实现大三阳SC的。