乙肝e抗原阴性的乙肝慢性乙肝病毒感染者从童年预测到成年

StephenW

Predictors of hepatitis B e antigen-negative hepatitis in chronic hepatitis B virus infected patients from childhood to adulthood

    Jia-Feng Wu1, Yu-Chun Chiu1,2, Kai-Chi Chang1,3, Huey-Ling Chen1,4, Yen-Hsuan Ni1,5, Hong-Yuan Hsu1 andMei-Hwei Chang1,4,*

DOI: 10.1002/hep.28222

© 2015 by the American Association for the Study of Liver Diseases

Issue
Cover image for Vol. 62 Issue 4
Hepatology

Accepted Article (Accepted, unedited articles published online and citable. The final edited and typeset version of record will appear in future.)
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    1    Departments of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan
    2    Departments of Medical Education, National Taiwan University Children's Hospital, Taipei, Taiwan
    3    Departments of Emergency, National Taiwan University Children's Hospital, Taipei, Taiwan
    4    Departments of Hepatitis Research Center, National Taiwan University Children's Hospital, Taipei, Taiwan
    5    Departments of Genetics, National Taiwan University Children's Hospital, Taipei, Taiwan

*Address correspondence to: Mei-Hwei Chang, MD., Department of Pediatrics, National Taiwan University Hospital; No. 8, Chung-Shan S. Rd., Taipei, Taiwan. TEL: (886-2)-23123456, ext. 71723, FAX: (886-2)-23938871; E-mail: [email protected]

Keywords:

    Gender;HBeAg-negative hepatitis;HBeAg-seroconversion;HBV genotype;Gender;HBeAg-negative hepatitis;HBeAg-seroconversion;HBV genotype

Abstract

Hepatitis B e antigen (HBeAg)-negative hepatitis is a clinical indicator of poor outcome for chronic hepatitis B virus (HBV) infection. This long-term prospective cohort study aimed to elucidate the predictors of developing HBeAg-negative hepatitis in chronic HBV-infected subjects followed from childhood to adulthood. We followed 434 HBeAg-positive chronic HBV-infected patients from a median age of 7.22 years (interquartile range [IQR]: 4.31-10.21 years). Spontaneous HBeAg-seroconversion occurred in 359 subjects at a median age of 13.93 years (IQR: 8.76-20.59 years), and 75 subjects developed HBeAg-seroconversion after antiviral therapy. These patients were followed for a median of 14.40 years (IRQ: 6.14-22.02 years) after HBeAg-seroconversion. Clinical data were analyzed to delineate the predictors of developing HBeAg-negative hepatitis. The HBV basal core promoter, and precore/core gene sequences were also evaluated in subjects with and without HBeAg-negative hepatitis. The overall annual incidence of HBeAg-negative hepatitis was 0.37% (95% confidence internal: 0.35, 0.39) in spontaneous HBeAg-seroconverters. The overall annual incidence of HBeAg-negative hepatitis increased to 2.64% in lamivudine-treated subjects but did not increase in those treated with interferon-alpha (0.58%). Male gender (hazard ratio [HR]: 3.15), HBV genotype C (HR: 4.40), HBeAg-seroconversion after 18 years of age (HR: 2.46) and lamivudine therapy prior to HBeAg seroconversion (HR: 1.42) were predictors of HBeAg-negative hepatitis in HBeAg seroconverters (p < 0.05). HBeAg-negative hepatitis subjects carried more A1762T/G1764A, C2063A, and A2131C HBV gene mutations than those without HBeAg-negative hepatitis.

Conclusions: HBeAg-seroconversion during childhood predicts a lower risk of HBeAg-negative hepatitis in later life. Interferon-alpha therapy may be an effective antiviral therapy beneficial in chronic HBV-infected children with severe inflammation that facilitates HBeAg-seroconversion in earlier life. This article is protected by copyright. All rights reserved.

StephenW

乙肝e抗原阴性的乙肝慢性乙肝病毒感染者从童年预测到成年

    贾锋WU1，宇春Chiu1,2，凯驰Chang1,3，休伊灵Chen1,4，颜轩Ni1,5，宏远Hsu1 andMei-Hwei Chang1,4，*

DOI：10.1002 / hep.28222

©2015年肝病研究的美国协会

问题
封面图片卷。 62第4期
肝病

接受第（接受，未编辑的文章在网上和可引用出版。最后编辑记录的排版本将出现在未来的。）
文章的altmetric比分2

    1部儿科，台大儿童医院，台北，台湾
    2部医学教育，台大儿童医院，台北，台湾
    紧急情况下，台大儿童医院，台北，台湾3部
    4部门肝炎研究中心，台大儿童医院，台北，台湾
    5系遗传学，台大儿童医院，台北，台湾

*通讯地址：美Hwei张医师，儿科，台大医院系; 8号仲山南路，台湾台北市。电话：（886-2）-23123456，分机。 71723，传真：（886-2）-23938871;电子信箱：[email protected]

关键词：

    性别; HBeAg阴性乙肝，大三阳，血清学转换; HBV基因型;性别; HBeAg阴性乙肝，大三阳，血清学转换; HBV基因型

抽象的

乙肝e抗原（HBeAg）阴性肝炎的慢性乙型肝炎病毒（HBV）感染的预后不良临床指标。这种长期的前瞻性队列研究的目的是阐明制定的慢性HBV感染者HBeAg阴性乙肝的预测，随后从童年到成年。我们跟着434 HBeAg阳性慢性HBV感染者从7.22年，中位年龄（四分位距[IQR]：4.31-10.21岁）。自发的HBeAg血清学转换发生在359科目13.93岁（IQR：8.76-20.59岁）年龄中位数，75科开发的HBeAg血清转换的抗病毒治疗后。随访14.40年（IRQ：6.14-22.02岁）中位数这些患者e抗原血清学转换后。临床资料进行分析，以划定发展HBeAg阴性乙肝的预测。该HBV基础核心启动子，前C和/芯基因序列进行了评价的科目和不HB​​eAg阴性乙肝。 HBeAg阴性乙肝的总体年发病率为0.37％（95％置信内部：0.35，0.39），自发的HBeAg血清转化。 HBeAg阴性乙肝的总体年发病率上升至2.64％，拉米夫定治疗的患者，但在那些与干扰素α（0.58％）处理后并没有增加。男性（危险比[HR]：3.15），HBV基因型C（HR：4.40）：和之前的HBeAg血清学转换（HR：1.42）拉米夫定治疗后，18岁（2.46 HR）的HBeAg血清学转换为HBeAg的预测在e抗原血清转化阴性肝炎（P <0.05）。 HBeAg阴性乙肝患者进行更A1762T / G1764A，C2063A和A2131C HBV基因突变比没有HBeAg阴性乙肝。

结论：童年时的HBeAg血清学转换的预测在以后的生活HBeAg阴性乙肝的风险较低。 α-干扰素治​​疗可能是一种有效的抗病毒治疗有益的慢性HBV感染的儿童有严重的炎症促进e抗原血清学转换的前半生。这篇文章是受版权保护的。版权所有。