慢性乙型肝炎e抗原阴性感染的特点和病程。

StephenW

Gastroenterol Hepatol. 2016 Dec 19. pii: S0210-5705(16)30163-7. doi: 10.1016/j.gastrohep.2016.11.002. [Epub ahead of print]
Characteristics and course of chronic hepatitis B e antigen-negative infection. [Article in English, Spanish]
Guardiola Arévalo A1, Gómez Rodríguez R2, Romero Gutiérrez M2, Gómez Moreno AZ2, García Vela A2, Sánchez Simón R3, Gómez Hernando C4, Andrés Esteban EM5.
Author information

• 1Servicio de Aparato Digestivo, Hospital Virgen de la Salud, Toledo, España; Servicio de Aparato Digestivo, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España. Electronic address: [email protected].
• 2Servicio de Aparato Digestivo, Hospital Virgen de la Salud, Toledo, España.
• 3Anatomía Patológica, Hospital Virgen de la Salud, Toledo, España.
• 4Microbiología, Hospital Virgen de la Salud, Toledo, España.
• 5Universidad Autónoma de Madrid, Madrid, España.
  

AbstractOBJECTIVE: To describe the epidemiological, analytical and histological characteristics and clinical course of hepatitis B virus (HBV) carriers with negative HBe antigen.
MATERIAL AND METHODS: Observational, retrospective cohort study of HBV carriers with negative HBe antigen (2005-2012), with no other causes of liver disease.
RESULTS: One hundred and thirty-eight patients were included, with mean age 40.5±12.2 years; 54% were women, and 38% were of foreign origin; the number of foreign patients significantly increased (P<.001) over the years. Transaminases were normal in nearly 75% and HBV-DNA was <2,000IU/ml in 56% of patients at diagnosis. There was a gradual decrease in HBV-DNA levels in inactive carriers over the study period. Fibrosis study was performed in 47% of patients by Fibroscan® or liver biopsy: 55.4% normal histology and 6.1% cirrhosis. Just over three quarters of patients (77.77%) were inactive carriers. Treatment was required in 15.5% of patients (20% because of cirrhosis and 80% HBeAg-negative chronic hepatitis B). Five patients cleared HBsAg (annual rate .94%), all of whom presented HBV-DNA <2,000IU/ml at diagnosis. Five patients developed complications (3.6%), 4 of them hepatocellular carcinoma (HCC), of which only 2 had cirrhosis. There was 1 HBV-related death (.72%).
CONCLUSION: Among HBV carriers with negative HBe antigen, inactive HBs-Ag carriers are predominant. HBV-DNA gradually decreases in the first few years after diagnosis. Morbidity and mortality are low, especially if glutamic pyruvic transaminase (GPT) is normal and HBV-DNA levels are low at diagnosis. Treatment is needed in a considerable number of patients. HCC is the most frequent complication, even in the absence of cirrhosis.

Copyright © 2016 Elsevier España, S.L.U., AEEH y AEG. All rights reserved.

KEYWORDS: ADN; Antígeno HBe(–); DNA; Glutamic pyruvic transaminase; Glutámico pirúvico transaminasa; HBe antigen-negative chronic hepatitis; Hepatitis B virus; Hepatitis crónica antígeno HBe(–); Negative HBe antigen; Virus de la hepatitis B

PMID:28007350DOI:10.1016/j.gastrohep.2016.11.002

StephenW

Gastroenterol Hepatol。 2016 Dec 19. pii：S0210-5705（16）30163-7。 doi：10.1016 / j.gastrohep.2016.11.002。 [打印前的电子版]
慢性乙型肝炎e抗原阴性感染的特点和病程。
[中文，西班牙文]
GuardiolaArévaloA1，GómezRodríguezR2，RomeroGutiérrezM2，GómezMoreno AZ2，GarcíaVela A2，SánchezSimónR3，GómezHernando C4，AndrésEsteban EM5。
作者信息

    1 Servicio de Aparato Digestivo，Hospital Virgen de la Salud，Toledo，España; Servicio de Aparato Digestivo，Hospital Universitario de Fuenlabrada，Fuenlabrada，Madrid，España。电子地址：[email protected]。
    2Servicio de Aparato Digestivo，Hospital Virgen de la Salud，Toledo，España。
    3AnatomíaPatológica，Hospital Virgen de la Salud，Toledo，España。
    4Microbiología，Hospital Virgen de la Salud，Toledo，España。
    马德里，西班牙马德里自治区。

抽象
目的：

描述具有阴性HBe抗原的乙型肝炎病毒（HBV）携带者的流行病学，分析和组织学特征和临床病程。
材料与方法：

观察性，回顾性队列研究HBV携带者阴性HBe抗原（2005-2012），没有其他肝脏疾病的原因。
结果：

纳入138例患者，平均年龄40.5±12.2岁; 54％为女性，38％为外国血统;外国患者数量显着增加（P <0.001）。转氨酶在正常的近75％和HBV-DNA <2000IU / ml在56％的诊断患者。在研究期间，在不活动载体中HBV-DNA水平逐渐降低。在47％的患者中进行纤维化研究或肝活检：55.4％正常组织学和6.1％肝硬化。只有四分之三的病人（77.77％）是不活动载体。在15.5％的患者中需要治疗（20％因为肝硬化和80％的HBeAg阴性的慢性乙型肝炎）。 5例患者清除HBsAg（年率为94％），所有患者在诊断时呈现HBV-DNA <2000IU / ml。 5例患者出现并发症（3.6％），其中4例为肝细胞癌（HCC），其中仅2例为肝硬化。有1例HBV相关死亡（.72％）。
结论：

在具有阴性HBe抗原的HBV载体中，无活性的HBs-Ag载体是主要的。 HBV-DNA在诊断后的最初几年逐渐减少。发病率和死亡率低，特别是如果谷氨酸丙酮酸转氨酶（GPT）正常，HBV-DNA水平在诊断时低。需要在相当多的患者中进行治疗。 HCC是最常见的并发症，即使在没有肝硬化的情况下。

版权所有©2016 ElsevierEspaña，S.L.U.，AEEH y AEG。版权所有。
关键词：

ADN; AntígenoHBe（ - ）;脱氧核糖核酸;谷氨酸丙酮酸转氨酶;哥伦比亚葡萄牙HBe抗原阴性慢性肝炎;乙型肝炎病毒;甲型肝炎病毒（ - ）;阴性HBe抗原;乙型肝炎病毒

PMID：
    28007350
DOI：
    10.1016 / j.gastrohep.2016.11.002