Fan Hui-min, Yang Zhan, Zhang Chun-lan, Li Wen-li
Guangzhou Eighth People's Hospital, Guangzhou 510060, China.
Zhonghua Gan Zang Bing Za Zhi. 2007 May;15(5):334-7.
To study the liver histopathological features of chronic HBV carriers and inactive HBsAg carriers.
Liver biopsies were performed on 189 chronic HBV carriers and 30 inactive HBsAg carriers (219 cases in total). All of them had a normal serum ALT value; they were then followed-up for more than 6 months. HBsAg and HBcAg were detected by immunohistochemistry. The circulating HBV DNA loads and serologic markers of HBV were examined at the same time. Grades of liver necrosis/inflammation and fibrosis were compared between the patients regarding their HBV DNA positivity or negativity. The relationships between the HBeAg positivity and degrees of liver histological changes were evaluated. The grades of liver necrosis/inflammation and fibrosis were compared between three age groups: younger than 18 years, 18-40, and older than 40 years.
Two hundred eight carriers of the total 219 (95.0%) had histological liver changes. Fifty percent (104/208) of them had mild histological changes (G0-1/S0-1), while more severe changes (G3-4 and/or S3-4) were found in 18 out of the 208. There were no significant differences in the grades of liver necrosis/inflammation and fibrosis between the chronic HBV carriers and the inactive HBsAg carriers. Among the serologic HBV DNA positive carriers, hepatic fibrosis was more severe in the HBeAg negative group than in the positive group (chi2 = 9.551, P = 0.008), but no differences of the necrosis/inflammation grades were seen between the two groups. The rate of severe fibrosis (S3-4) was 21.1% in those carriers older than 40 years but was 7.7% in patients younger than 18 years. However, no statistically significant differences in degrees of liver inflammation and fibrosis were found among the three age groups. HBcAg positive rate was 100% in the liver tissues of all the chronic HBV carriers, but only in 33.3% in the inactive HBsAg carriers.
The majority of our HBV carriers have liver inflammation and fibrosis. More severe histological changes were found in 8.65% of them. Liver fibrosis existed in the carriers with negative HBeAg and in those older than 40 years. HBcAg was found in hepatic tissues while their serological HBV DNA was negative.
研究慢性HBV携带者和HBsAg阴性非活动性携带者的肝脏组织病理学特征。
对189例慢性HBV携带者和30例HBsAg阴性非活动性携带者（共219例）进行肝脏活检。所有患者血清ALT值均正常；随后对他们进行了6个月以上的随访。采用免疫组织化学法检测HBsAg和HBcAg。同时检测循环中的HBV DNA载量和HBV血清学标志物。比较患者中HBV DNA阳性或阴性者的肝坏死/炎症分级及纤维化分级。评估HBeAg阳性与肝脏组织学改变程度之间的关系。比较三个年龄组（小于18岁、18 - 40岁和大于40岁）的肝坏死/炎症分级及纤维化分级。
219例携带者中208例（95.0%）有肝脏组织学改变。其中50%（104/208）有轻度组织学改变（G0 - 1/S0 - 1），而208例中有18例有更严重的改变（G3 - 4和/或S3 - 4）。慢性HBV携带者和HBsAg阴性非活动性携带者之间的肝坏死/炎症分级及纤维化分级无显著差异。在血清学HBV DNA阳性携带者中，HBeAg阴性组的肝纤维化比阳性组更严重（χ2 = 9.551，P = 0.008），但两组之间的坏死/炎症分级无差异。大于40岁的携带者中重度纤维化（S3 - 4）发生率为21.1%，而小于18岁的患者中为7.7%。然而，三个年龄组之间的肝脏炎症和纤维化程度无统计学显著差异。所有慢性HBV携带者肝组织中的HBcAg阳性率为100%，而HBsAg阴性非活动性携带者中仅为33.3%。
大多数HBV携带者有肝脏炎症和纤维化。其中8.65%有更严重的组织学改变。HBeAg阴性的携带者及大于40岁的携带者存在肝纤维化。肝组织中可检测到HBcAg，而其血清学HBV DNA为阴性。
