ABSTRACT
0bjective To analyze the factors related tO the changes of liver pathology in hepatitis B e antigen (HBeAg) negative chronic hepatitis B (CHB) patients.Methods Two hundred and eighty-eight HBeAg negative CHB patients were enrolled.Bivariate Pearson correlation was employed to analyze the correlation of different age,gender,alanine aminotransferase (ALT) level,the immunohistochemistry results of hepatitis B surface antigen (HBsAg) and hepatitis B core antigen (HBcAg) in liver tissue with hepatitis B virus (HBV) DNA level,changes of liver pathology.Results The inflammation grades and fibrosis stages of livertissuesinmale were 1.72±1.23 and 1.71±1.24,respectively;1.25±1.39 and 1.21±1.40 in female,respectively,which were significantly different (t=2.398,t-2.551;both P<O.05).The HBV DNA levels in male were higher than those in female,but not significantly.The HBV DNA levels,inflammation grades and fibrosis stages of liver tissues in patients>40 years old were all significantly higher than those<40 years old(t一2.060,t一2.536,t=2.808;all P<0.05).In patients with normal ALT levels,75 cases (52.03%) showed HBV DNA level≤1×103 copy/mL,56(38.89%) showed≥G2 of liver tissues; the ALT level and inflammation grade of liver tissues was significantly correlated(r:O.244,P-O.004).In patients with elevated ALT 1evels,42 cases (31.57%) showed HBV DNA level≤1×10s copy/mL,89 (66.92%) showed≥G2 of liver tissues; the ALT level and inflammation grade of liver tissues was not significantly correlated (r=0.007,P=0.939) .The inflammation/fibrosis of liver tissues,HBV DNA levels in patients with both HBsAg and HBcAg positive in liver tissues were significantly higher than those in other patients (P<O.05).There was significant relationship between serum HBV DNA level and inflammation grade of liver tissue (r=0.349, P<0.05).Conclusions Gender,age,serum HBV DNA level and expressions of HBsAg.HBcAg in liver tissues are indicators of inflammation grade Of liver tissue in HBeAg negative CHB patients.The factors of male,older age,high serum HBV DNA level,HBsAg and HEcAg double positive in liver tissues indicate that the inflammation grades of 1iver tissues are more severe.Even patients with normal ALT level and serum HBV DNA level≤1×100 copy/mL,30% showed significant liver inflammation in HBeAg negative CHB patients.Therefore.frequent follow-up and if possible.liver biopsy should be considered tO early identify patients who need treatment.
ABSTRACT
Objective To determine the relationship between HBeAg and HBV DNA levels and grading of liver inflammation in patients with chronic hepatitis B. Methods Serum HBeAg and HBV DNA were assayed by MEIA and PCR in 74 patients with HBeAg-negative and 73 patients with HBeAg-positive chronic hepatitis B who had undergone liver biopsy and pathological grading. Results The serum HBV DNA levels in 27 patients(36%) HBeAg-negative chronic hepatitis B were higher 10~5 copies/ml.The number of patient at the HBV DNA level increase along with G1～G4 grading ascendant.The correlation between two factors has statistically remarkable significance.Those serum HBeAg quantitative levels are 0～29 PEIU/ml. The number of HBeAg quantitative-positive patients increase also along with G1～G4 grading ascendant and the correlation between two items has statistically significance.However,there are no relationship between serum HBeAg and HBV DNA and G1～G4 grading in 73 patients with HBeAg-positive chronic hepatitis B whose HBV DNA levels are higher than 10~5 copies/ml. Conclusions Serum HBV DNA level is the indicator by which grading of liver inflammation can be judged in the patients with HBeAg-negative chronic hepatitis B and former is positively interrelated with latter significantly.That Serum HBeAg level is low but HBV DNA duplicate actively may indicate that there is C-zone mutation in 36% patients with HBeAgnegative chronic hepatitis B.Serum HBV DNA level cannot reflect grading of liver inflammation in the patients with HBeAg-positive chronic hepatitis B.