高加索乙型肝炎e抗原阴性慢性感染患者的结果：一项长期的

StephenW

J Med Virol. 2020 Apr 28. doi: 10.1002/jmv.25950. [Epub ahead of print]
Outcome in Caucasian patients with hepatitis B e antigen negative chronic infection: a long-term observational cohort study.
Koc ÖM1,2,3,4, Robaeys G1,2,5, Topal H6, Bielen R1,2, Busschots D1,2, Fevery J5, Koek GH4,7,8, Nevens F5.
Author information

1
    Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium.
2
    Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.
3
    Department of Medical Microbiology, Maastricht University Medical Centre, Maastricht, the Netherlands.
4
    School of Nutrition and Translational Research in Metabolism (NUTRIM), University Maastricht, Maastricht, the Netherlands.
5
    Department of Gastroenterology and Hepatology, University Hospitals KULeuven, Leuven, Belgium.
6
    Department of Abdominal Surgery, University Hospitals KU Leuven, Leuven, Belgium.
7
    Department of Internal Medicine, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre, Maastricht, the Netherlands.
8
    Department of visceral surgery and transplantation, University Hospital of the RWTH, Aachen, Germany.

Abstract
BACKGROUND & AIMS:

Sensitive PCR assays to measure HBV DNA became only available the last decade. Hence, the long-term outcome of Caucasian patients in Western Europe with hepatitis B e antigen (HBeAg)-negative chronic infection, especially with a baseline HBV DNA level > 2,000 IU/mL, is still unclear.
METHODS:

Out of a cohort of 1,936 chronic HBV patients, 413 Caucasian individuals were identified with HBeAg-negative chronic infection, defined as persistently normal alanine aminotransferase (ALT) levels and HBV DNA levels < 20,000 IU/mL.
RESULTS:

During a mean follow-up of 12 years, 366 (88.6%) maintained a HBeAg-negative chronic infection status, whereas 25 (6.1%) developed chronic active hepatitis (CAH). Nine of these 25 CAH cases were related to immunosuppression. Twenty-two (5.3%) individuals had ALT > 2 x ULN due to non-HBV related causes. The cumulative probability of spontaneously developing CAH after 10 years was almost exclusively seen in patients with baseline HBV DNA level > 2,000 IU/mL (11.7% vs 1.2%, p < 0.001). Advanced liver disease developed significantly more in patients with baseline HBV DNA level > 2,000 IU/mL (5.2% vs 1.5%, p = 0.018) and occurred especially in patients with obesity (16.7% vs 4.2% p = 0.049). The incidence of hepatocellular carcinoma was 0.0%.
CONCLUSIONS:

Caucasian patients with HBeAg-negative chronic infection and baseline HBV DNA level of < 2,000 IU/mL have an excellent long-term prognosis in the absence of immunosuppressive therapy. However, patients with baseline HBV DNA level > 2,000 IU/mL are at risk to develop advanced liver disease. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.
KEYWORDS:

Caucasian Race; Chronic Hepatitis B; HBV DNA; HBeAg-negative chronic infection; alanine aminotransferase; inactive HBV carrier

PMID:
    32343427
DOI:
    10.1002/jmv.25950

StephenW

J Med Virol。 2020年4月28日。doi：10.1002 / jmv.25950。 [Epub提前发行]
高加索乙型肝炎e抗原阴性慢性感染患者的结果：一项长期的观察性队列研究。
KocÖM1,2,3,4，Robaeys G1,2,5，Topal H6，Bielen R1,2，Busschots D1,2，Fevery J5，Koek GH4，7，8，Nevens F5。
作者信息

1个
比利时亨克Ziekenhuis Oost-Limburg胃肠病学和肝病学系。
2
哈瑟尔特大学医学与生命科学学院，比利时哈瑟尔特。
3
荷兰马斯特里赫特，马斯特里赫特大学医学中心医学微生物学系。
4
营养和转化代谢研究学院（NUTRIM），荷兰马斯特里赫特大学。
5
比利时鲁汶库鲁芬大学医院消化内科和肝病科。
6
比利时鲁汶大学鲁汶大学医院腹部外科。
7
荷兰马斯特里赫特马斯特里赫特大学医学中心消化内科和消化内科。
8
德国亚琛工业大学附属医院内脏外科和移植科。

抽象
背景与目的：

用于测量HBV DNA的灵敏PCR分析仅在最近十年才可用。因此，西欧高加索人患有乙型肝炎e抗原（HBeAg）阴性慢性感染，特别是基线HBV DNA水平> 2,000 IU / mL的长期患者，尚不清楚。
方法：

在1,936名慢性HBV患者队列中，鉴定出413名白人，患有HBeAg阴性慢性感染，定义为持续正常的丙氨酸转氨酶（ALT）水平和HBV DNA水平<20,000 IU / mL。
结果：

在平均12年的随访中，有366名（88.6％）维持HBeAg阴性的慢性感染状态，而25名（6.1％）则患有慢性活动性肝炎（CAH）。这25例CAH病例中有9例与免疫抑制有关。由于非HBV相关原因，二十二（5.3％）个人的ALT> 2 x ULN。基线HBV DNA水平> 2,000 IU / mL的患者几乎只能看到10年后自发发展CAH的累积概率（11.7％vs 1.2％，p <0.001）。基线HBV DNA水平> 2,000 IU / mL的患者进展为晚期肝病的比例明显更高（5.2％vs 1.5％，p = 0.018），尤其是在肥胖患者中（16.7％vs 4.2％p = 0.049）。肝细胞癌的发生率为0.0％。
结论：

在没有免疫抑制治疗的情况下，患有HBeAg阴性慢性感染且基线HBV DNA水平<2,000 IU / mL的白种人患者具有良好的长期预后。但是，基线HBV DNA水平> 2,000 IU / mL的患者有发展为晚期肝病的风险。本文受版权保护。版权所有。

本文受版权保护。版权所有。
关键字：

高加索人种；慢性乙型肝炎； HBV DNA； HBeAg阴性慢性感染；丙氨酸转氨酶；非活动性乙肝病毒携带者

PMID：
32343427
DOI：
10.1002 / jmv.25950