Amarapurkar D N, Baijal R, Kulshrestha P P, Agal S, Chakraborty M R, Pramanik S S
Department of Gastroenterology, Bombay Hospital, Mumbai.
Indian J Gastroenterol. 2002 May-Jun;21(3):99-101.
Although chronic hepatitis B occurs in hepatitis B e antigen (HBeAg)-negative patients, its prevalence and clinical significance are not known.
To determine the prevalence and profile of HBeAg-negative chronic hepatitis B virus (HBV) infection.
A retrospective analysis of 363 consecutive patients (mean age 36 y; 288 men) with chronic HBV infection was performed. All patients were HBsAg-positive. Tests for liver profile, HBeAg and anti-HBe antibody were performed in all patients. Serum HBV DNA was tested using branched DNA assay in 245 patients. The patients were classified into three groups: no cirrhosis with normal ALT levels, no cirrhosis with elevated ALT levels, and clinical or histological evidence of cirrhosis.
Of 363 patients, 141 (39%) were HBeAg-positive and 222 (61%) HBeAg-negative. Of HBeAg-negative patients, 120 (54%) had normal ALT, 45 (20%) had elevated ALT and 57 (26%) had evidence of cirrhosis; corresponding figures in the HBeAg-positive patients were 40 (28%), 66 (47%) and 35 (25%). HBV DNA was positive in 53 of 131 (40%) HBeAg-negative patients tested; of these 53 patients, 9 (17%) had normal ALT, 20 (38%) had elevated ALT and 24 (45%) had cirrhosis. Thus, 72% of HBeAg-positive and 46% of HBeAg-negative patients had elevated ALT and/or cirrhosis. Among the latter group, 83% of HBV DNA-positive patients had elevated ALT and/or cirrhosis. Overall, 18% of HBsAg-positive patients had HBeAg-negative, HBV DNA-positive liver disease.
HBeAg-negative chronic hepatitis B is not an uncommon and benign entity and chronic liver disease develops in a significant proportion of such patients.
尽管慢性乙型肝炎发生于乙肝e抗原（HBeAg）阴性患者中，但其患病率及临床意义尚不清楚。
确定HBeAg阴性慢性乙型肝炎病毒（HBV）感染的患病率及特征。
对363例连续的慢性HBV感染患者（平均年龄36岁；男性288例）进行回顾性分析。所有患者HBsAg均为阳性。对所有患者进行肝功能、HBeAg及抗-HBe抗体检测。245例患者采用分支DNA分析法检测血清HBV DNA。患者分为三组：无肝硬化且ALT水平正常、无肝硬化但ALT水平升高、有临床或组织学肝硬化证据。
363例患者中，141例（39%）HBeAg阳性，222例（61%）HBeAg阴性。HBeAg阴性患者中，120例（54%）ALT正常，45例（20%）ALT升高，57例（26%）有肝硬化证据；HBeAg阳性患者相应数字分别为40例（28%）、66例（47%）和35例（25%）。131例接受检测的HBeAg阴性患者中53例（40%）HBV DNA阳性；这53例患者中，9例（17%）ALT正常，20例（38%）ALT升高，24例（45%）有肝硬化。因此，72%的HBeAg阳性患者和46%的HBeAg阴性患者ALT升高和/或有肝硬化。在后一组中，83%的HBV DNA阳性患者ALT升高和/或有肝硬化。总体而言，18%的HBsAg阳性患者患有HBeAg阴性、HBV DNA阳性肝病。
HBeAg阴性慢性乙型肝炎并非罕见的良性疾病，相当一部分此类患者会发生慢性肝病。
