Peng Jie, Luo Kangxian, Zhu Youfu, Guo Yabing, Zhang Lian, Hou Jinlin
Department of Infectious Diseases, Nanfang Hospital, First Military Medical University, Guangzhou 510515, China.
Chin Med J (Engl). 2003 Sep;116(9):1312-7.
To study the clinical and histological features of chronic hepatitis B (CHB) with negative hepatitis B e-antigen (HBeAg).
A total of 743 in-patients with chronic hepatitis B were recruited into the study and divided into two groups according to the HBeAg status. The correlation among alanine transaminase (ALT) levels, hepatitis B virus (HBV) DNA semiquantification, and the liver histopathological data were detected.
Of the 743 successive in-patients, 267 (35.9%) were HBeAg-negative. The HBDAG-negative group had significantly lower serologic HBV DNA levels (63.0% of < 100 pg/ml) vs HBeAg-positive (42.6%, P < 0.001), while more sever inflammation (58.1% of inflammatory scores of histological activity index (HAIinf > or = 9) vs HBeAg-positive group (46.0%, P < 0.001) and severe fibrosis (45.3% of fibrosis scores of histological activity index (HAIfib > or = 3) vs HBeAg-positive group (27.9%, P < 0.001) of liver histology. In HBeAg-positive patients, increasing ALI levels were significantly associated with high inflammation and fibrosis scores and low HBV DNA levels. However, it was not the case in the HBeAg-negative cases. In HBeAg-positive patients, 91.3% of them had HAIinf > or = 9 and 65.7% had HAIfib > or = 3 with HBV DNA > 100 pg/ml, while 8.2% of them had HAIinf > or = 9 and 12.3% had HAIfib > or = 3 with HBV DNA < 20 pg/ml, indicating an obverse correlation between HBV DNA levels and histology scores.
As regards clinical and histological background, the chronic HBeAg-negative hepatitis B is a different subpopulation from the HBeAg-positive counterpart.
研究乙肝e抗原（HBeAg）阴性的慢性乙型肝炎（CHB）的临床和组织学特征。
共纳入743例慢性乙型肝炎住院患者，根据HBeAg状态分为两组。检测丙氨酸转氨酶（ALT）水平、乙肝病毒（HBV）DNA半定量与肝脏组织病理学数据之间的相关性。
在743例连续住院患者中，267例（35.9%）为HBeAg阴性。HBeAg阴性组血清HBV DNA水平显著低于HBeAg阳性组（<100 pg/ml者占63.0% 对比 HBeAg阳性组的42.6%，P<0.001），而肝脏组织学炎症更严重（组织学活动指数（HAI）炎症评分>或=9者占58.1% 对比 HBeAg阳性组的46.0%，P<0.001）以及严重纤维化（组织学活动指数（HAI）纤维化评分>或=3者占45.3% 对比 HBeAg阳性组的27.9%，P<0.001）。在HBeAg阳性患者中，ALT水平升高与高炎症和纤维化评分以及低HBV DNA水平显著相关。然而，在HBeAg阴性患者中并非如此。在HBeAg阳性患者中，HBV DNA>100 pg/ml时，91.3%的患者HAI炎症评分>或=9且65.7%的患者HAI纤维化评分>或=3，而HBV DNA<20 pg/ml时，分别有8.2%和12.3%的患者HAI炎症评分>或=9以及HAI纤维化评分>或=3，表明HBV DNA水平与组织学评分呈正相关。
就临床和组织学背景而言，慢性HBeAg阴性乙型肝炎是与HBeAg阳性患者不同的亚群。
