Choi Hye Jin, Ko Soon Young, Choe Won Hyeok, Seo Yeon Seok, Kim Ji Hoon, Byun Kwan Soo, Kim Young Seok, Kim Seung Up, Baik Soon Koo, Cheong Jae Youn, Kim Tae Yeob, Kwon Oh Sang, Kim Jeong Han, Lee Chang Hong, Kwon So Young
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
Korean J Hepatol. 2011 Dec;17(4):307-12. doi: 10.3350/kjhep.2011.17.4.307.
BACKGROUND/AIMS: The incidence of Hepatitis B has significantly declined since the introduction of an HBV vaccination program. The aim of this study was to investigate recent clinical features of acute viral hepatitis B (AVH-B) in Korea.
A total of 2241 patients with acute viral hepatitis were enrolled and their data were collected from nine medical-centers between January 2006 and December 2009.
One hundred nineteen (5.3%) of the 2241 were diagnosed as AVH-B. Among 78 patients with AVH-B whose data were analyzed, 50 were male, and the mean age was 38.6 years. In an initial test, mean AST, ALT and total-bilirubin levels were 1296.2 IU/L, 2109.6 IU/L and 9.3 mg/dl, respectively. Positivity frequencies for HBeAg and anti-HBe were 55.1% and 67.9%, respectively, and the mean HBV DNA level was 5.2 log10 copies/ml. The mean length of hospitalization was 11.6 days. During follow-up, AST, ALT and total bilirubin levels were normalized or near-normalized in all patients without serious complications. Sixty-three of 66 (95.4%) patients showed HBsAg loss and 37 (56.1%) patients showed HBsAg seroconversion. Only 3 patients (4.5%) showed persistent hepatitis B viremia. There was no case of death or liver transplantation. Nine patients (11.3%) had received anti-viral agents and their clinical outcomes were not significantly different from those of patients treated without antiviral agents.
The prevalence of AVH-B among acute hepatitis patients is relatively low in Korea. AVH-B infection can be cured without complications in almost all patients, regardless of antiviral treatment.
背景/目的:自实施乙肝疫苗接种计划以来,乙肝发病率显著下降。本研究旨在调查韩国急性病毒性乙型肝炎(AVH-B)的近期临床特征。
共纳入2241例急性病毒性肝炎患者,并于2006年1月至2009年12月期间从9个医疗中心收集他们的数据。
2241例患者中有119例(5.3%)被诊断为AVH-B。在分析数据的78例AVH-B患者中,男性50例,平均年龄38.6岁。初次检测时,平均谷草转氨酶(AST)、谷丙转氨酶(ALT)和总胆红素水平分别为1296.2 IU/L、2109.6 IU/L和9.3 mg/dl。HBeAg和抗-HBe的阳性率分别为55.1%和67.9%,平均乙肝病毒(HBV)DNA水平为5.2 log10拷贝/ml。平均住院时间为11.6天。随访期间,所有患者的AST、ALT和总胆红素水平均恢复正常或接近正常,无严重并发症。66例患者中有63例(95.4%)HBsAg转阴,37例(56.1%)患者出现HBsAg血清学转换。仅3例患者(4.5%)出现持续性乙肝病毒血症。无死亡或肝移植病例。9例患者(11.3%)接受了抗病毒药物治疗,其临床结局与未接受抗病毒药物治疗的患者无显著差异。
在韩国,急性肝炎患者中AVH-B的患病率相对较低。几乎所有患者的AVH-B感染均可治愈且无并发症,无论是否接受抗病毒治疗。