急性乙型肝炎患者感染

StephenW

Clin Infect Dis. 2013 Aug 6. [Epub ahead of print]

High Levels of Hepatitis B Virus After the Onset of Disease Lead to Chronic
Infection in Patients With Acute Hepatitis B

Yotsuyanagi H, Ito K, Yamada N, Takahashi H, Okuse C, Yasuda K, Suzuki M,
Moriya K, Mizokami M, Miyakawa Y,KoikeK Source
Department of Internal Medicine, Graduate School of Medicine, University of
Tokyo, Bunkyo.
Abstract
Background.
Some patients with acute hepatitis B virus (HBV) infection
develop chronic infection. However, the method for identifying these
patients 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 from the onset. 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 6 (2.8%) patients, including 5 with genotype A, failed to
clear HBsAg within 12 months. Levels of HBsAg at 12 weeks and HBV DNA at 4
weeks 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 and
those who did not (P < .01 and P < .05, respectively).
Conclusions.
In acute HBV infection, clearance of HBV may happen between 6 and 12 months
from the onset. Only those who fail to clear HBV within 12 months from the
onset may develop chronic infection.

StephenW

背景。
有些患者急性B型肝炎病毒（HBV）感染
发展成慢性感染。然而，该方法确定这些
患者尚未建立。方法。我们跟着215
急性HBV感染，直至清除乙肝患者
表面抗原（HBsAg）或慢性感染的发展。水平的
HBsAg和HBV DNA的串行监控从发病。的结果。的
215名患者，113（52.5％）拥有HBV基因型A，26（12.0％）B基因型，
和73（34.0％），C基因型25-215（9.8％）发展为慢性
感染，> 6个月的持续的HBsAg。率的
慢性A，B和C基因型为12.4％，3.8％和8.2％。在21个
患者中，只有6例（2.8％），其中包括5基因型，未能
在12个月内清除HBsAg的。 4在12周和HBV DNA的HBsAg的级别
用于区分患者谁成为慢性从周
这些谁没有（P <0.001，P <0.001）。同样地，
8周时在第12周和HBV DNA的HBsAg的水平是有用的
区分谁失去了在12个月内，乙肝表面抗原，患者
这些谁没有（P<0.01和P <0.05，分别）。结论。在
急性HBV感染，HBV清除可能发生在6个月和12个月之间
从发病。只有那些谁不能清除HBV起12个月内
起病可发展为慢性感染。