HBV DNA阴性的CHB患者一年后肝脏的病理变化。

StephenW

Infect Agent Cancer. 2019 Dec 10;14:48. doi: 10.1186/s13027-019-0265-2. eCollection 2019.
Pathological changes of liver one year later in CHB patients with negative HBV DNA.
Shanshan W1, Xinfang D2, Shuihong Y3, Kecong L3, Jinjin Q1, Zhi C1, Feng C1.
Author information

1
    1State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, 310003 Hangzhou China.
2
    Beilun People's Hospital, Ningbo, 315800 China.
3
    Beilun Second People's Hospital, Ningbo, 315809 China.

Abstract
Background:

In this study, we aim to determine the hepatic pathological changes in HBV DNA-negative chronic Hepatitis B (CHB) patients after 12-month antiviral therapy.
Methods:

Blood routine indicators including platelet count (PLT) and white blood cell (WBC) were determined. The coagulation function was evaluated by determining the prothrombin time (PT) and prothrombin time activity (PTA), together with the HBV DNA quantification and alpha fetoprotein (AFP). The virology data included hepatitis B surface antigen (HBsAg)/antibodies against hepatitis B surface antigen (anti-HBs), hepatitis B e antigen (HBeAg)/antibodies against hepatitis B e antigen (anti-HBe) and antibodies against hepatitis B core antigen (anti-HBc) were tested. Pathological assay was performed to the liver puncture tissues. Based on the HBV DNA data in the 12-month follow-up of the cases that received anti-viral therapy during this time, the experimental group was divided into group A (HBV DNA negative at the baseline level, HBV DNA negative after 12 months, N = 79) and group B (HBV DNA negative at the baseline level, HBV DNA turning to be positive after 12 months, N = 13). Statistical analysis was performed on the each test index of the two groups.
Results:

The inflammation grade of group A showed significant improvement after 12-month treatment (P < 0.05). The pathological inflammation grade of group B was increased after one year, and the liver function indices and the PTA (P < 0.05) levels were all increased. Pathological results indicated that the proportion of disease progression in group A was decreased after 12-month follow-up while that proportion was increased in group B. Significant differences were noticed in AFP levels between the patients with progression in group A and those with progression in group B.
Conclusion:

Negative HBV DNA does not mean a controlled hepatitis B. Hepatitis B patients transferred to HBV DNA positivity during the anti-viral therapy are easily to show disease progression, and then special attention should be paid to the HBV DNA monitoring. Meanwhile, close monitoring to the changes of liver function, PTA and AFP levels may help to detect changes on the disease in a timely manner.

© The Author(s). 2019.
KEYWORDS:

Blood routine; Coagulation function; HBV DNA; Hepatitis B; Liver function; Pathological analysis

PMID:
    31827599
PMCID:
    PMC6902453
DOI:
    10.1186/s13027-019-0265-2

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StephenW

感染剂癌症。 2019十二月10; 14：48。 doi：10.1186 / s13027-019-0265-2。 eCollection 2019。
HBV DNA阴性的CHB患者一年后肝脏的病理变化。
杉杉W1，新房D2，水红Y3，科聪L3，金津Q1，智C1，冯C1。
作者信息

1个
    1浙江大学医学院附属第一医院传染病诊断与治疗国家重点实验室，浙江杭州310003。
2
    宁波市北仑人民医院315800
3
    北仑市第二人民医院，宁波315809。

抽象
背景：

在这项研究中，我们旨在确定经过12个月的抗病毒治疗后，HBV DNA阴性的慢性乙型肝炎（CHB）患者的肝脏病理变化。
方法：

确定了血液常规指标，包括血小板计数（PLT）和白细胞（WBC）。通过确定凝血酶原时间（PT）和凝血酶原时间活性（PTA）以及HBV DNA定量和甲胎蛋白（AFP）评估凝血功能。病毒学数据包括乙型肝炎表面抗原（HBsAg）/乙型肝炎表面抗原抗体（anti-HBs），乙型肝炎e抗原（HBeAg）/乙型肝炎e抗原抗体（抗HBe）和乙型肝炎核心抗原抗体（抗HBc）进行了测试。对肝穿刺组织进行病理学测定。根据这段时间接受抗病毒治疗的患者在12个月随访中的HBV DNA数据，将实验组分为A组（基线水平HBV DNA阴性，在12个月后HBV DNA阴性） ，N = 79）和B组（基线水平HBV DNA阴性，HBV DNA在12个月后变为阳性，N = 13）。对两组的每个测试指标进行统计学分析。
结果：

治疗12个月后，A组的炎症等级明显改善（P <0.05）。一年后，B组病理炎症等级升高，肝功能指数和PTA水平均升高（P <0.05）。病理结果表明，在随访12个月后，A组疾病进展的比例降低了，而B组中疾病进展的比例有所提高。在A组进展的患者与A进展程度的患者之间，AFP水平存在显着差异。 B组
结论：

HBV DNA阴性并不意味着可控制的乙型肝炎。在抗病毒治疗期间转移至HBV DNA阳性的乙型肝炎患者很容易显示疾病进展，因此应特别注意HBV DNA监测。同时，密切监测肝功能，PTA和AFP水平的变化可能有助于及时发现疾病的变化。

©作者。 2019。
关键字：

血液常规；凝血功能； HBV DNA；乙型肝炎；肝功能;病理分析

PMID：
    31827599
PMCID：
    PMC6902453
DOI：
    10.1186 / s13027-019-0265-2

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StephenW

https://infectagentscancer.biome ... 6/s13027-019-0265-2