Bradbear R A, Robinson W N, Cooksley W G, Halliday J W, Harris O D, Powell L W
Q J Med. 1984 Spring;53(210):279-88.
We describe the features at presentation of 104 patients with biopsy-proven chronic hepatitis who presented in Brisbane in the period 1968-32. The mean period of follow-up was 59 months. Sex ratio (female : male) was 70 : 34 and the mean age was 37 years (range 3-83). Eighty-five (82 per cent) were born in Australia. Serological evidence of hepatitis B (HBV) infection was present in 24 (23 per cent). Analysis of the HBV marker positive and negative (non-B) groups revealed that the clinical and laboratory features of HBsAg positive chronic hepatitis were much less florid than those of non-B patients. However, the disturbances seen in hepatic histopathology were similar in severity, and the mortality in the HBsAg positive group exceeded that in the non-B group. The relative risk calculated on an actuarial basis was higher in HBsAg positive patients. In contrast to the experience of others, severe chronic active hepatitis remains an important problem in Brisbane but some features of the disease are altering. Several changes may be attributable to the increasing incidence of HBV-associated disease, and in addition, patients aged under 20 with non-B chronic hepatitis are now rarely seen. This is of interest in view of recent reports of decreased incidence of another disease of disordered immune response, rheumatoid arthritis.
我们描述了1968年至1982年期间在布里斯班就诊的104例经活检证实为慢性肝炎患者的临床表现。平均随访时间为59个月。男女比例（女∶男）为70∶34，平均年龄为37岁（范围3至83岁）。其中85例（82%）出生在澳大利亚。24例（23%）有乙型肝炎（HBV）感染的血清学证据。对HBV标志物阳性和阴性（非B型）两组的分析显示，HBsAg阳性慢性肝炎的临床和实验室特征远不如非B型患者明显。然而，肝脏组织病理学所见的病变严重程度相似，HBsAg阳性组的死亡率超过非B型组。根据精算得出的相对风险在HBsAg阳性患者中更高。与其他人的经验不同，严重慢性活动性肝炎在布里斯班仍然是一个重要问题，但该病的一些特征正在发生变化。一些变化可能归因于HBV相关疾病发病率的上升，此外，目前20岁以下非B型慢性肝炎患者已很少见。鉴于最近有关另一种免疫反应紊乱疾病类风湿关节炎发病率下降的报道，这一点很有意思。
