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ObjectiveTo investigate the situation and development trend of the disease burden of acute hepatitis B in China in 1990 — 2019. MethodsThe Global Burden of Disease 2019 was used to analyze the incidence rate， mortality rate， and disability-adjusted life year （DALY） rate of acute hepatitis B in different sex and age groups and predict the trend of the incidence rate of acute hepatitis B. ResultsIn 2019， the incidence rate， mortality rate， and DALY rate of acute hepatitis B in China were 1 623.71/100 000， 0.20/100 000， and 10.04/100 000 respectively， which were reduced by 42.03%， 79.38%， and 80.21%， respectively， compared with the data in 1990， and women showed lower incidence rate， mortality rate， and DALY rate of acute hepatitis B than men. In 2019， the 20～<54 years group had the highest incidence rate （2 285.85/100 000） and DALY rate （10.53/100 000）， and the ≥55 years group had the highest mortality rate of 0.52/100 000. The Joinpoint regression model analysis showed that the incidence rate， mortality rate， and DALY rate of acute hepatitis B in China tended to decrease from 1990 to 2019， with an average annual percent change of -1.9%， -5.2%， and -5.5%， respectively （P<0.05）. The grey prediction model GM （1，1） showed that the incidence rate of acute hepatitis B will decrease from 2020 to 2030 in China. ConclusionThe disease burden of acute hepatitis B tended to decrease from 1990 to 2019 in China， indicating that the prevention and treatment measures for acute hepatitis B have achieved a marked effect in China； however， due to the large population base of China， active preventive measures should be further adopted to reduce the disease burden of acute hepatitis B.
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Introduction: The prevalence of hepatitis B virus (HBV) infection has been declining nationwide throughout Brazil since the introduction of universal child vaccination. The vaccine is currently available for all ages. However, most of the adult population has not been vaccinated and may still be susceptible to it. Most of the cases reported to the Brazilian Notifiable Diseases Information System (Sistema de Informação de Agravos de Notificação - SINAN) are chronic, a consequence of early exposure in life. However, acute cases are the result of current transmission and may reveal the current dynamics of HBV circulation. Objective: To evaluate whether there is a change in the age distribution of acute hepatitis B in Brazil. Methods: To analyze the historical series of reported cases and incidence rates of acute hepatitis B by age group between 2007 and 2018, based on data reported to SINAN. Temporal trend was tested with non-parametric Cusick test. Results: The incidence rate fell from 1.02 (/ 100,000 inhabitants) in 2007 to 0.67 in 2018 (p=0.01). The drop was significant at all ages, except under 15 and over 60. The highest incidences (@1.0 / 100,000 inhab.) occurred between 20 and 59 years old. Conclusion: There is a progressive "aging" of acute hepatitis B cases in the country, probably due to the vaccine protection of younger people. A considerable portion of the older population is susceptible to HBV and may be exposed, especially by sexual route. Control measures such as vaccination and guidance for safe sex are needed.
Introdução: A prevalência da infecção pelo vírus da hepatite B (HBV) vem diminuindo em todo o Brasil desde a introdução da vacinação universal de crianças. Atualmente a vacina está disponível para todas as idades, porém a maior parte da população brasileira não foi vacinada e pode ainda ser suscetível. A maioria dos casos notificados ao Sistema de Informação de Agravos de Notificação (SINAN) é crônica, consequência de contágio antigo. Contudo os casos agudos são fruto de transmissão atual e podem revelar-nos a dinâmica atual da circulação do HBV. Objetivo: Avaliar se há mudança na distribuição etária da incidência da hepatite B aguda no Brasil. Métodos: Analisar a série histórica de casos notificados e as taxas de incidência de hepatite B aguda por faixa etária entre 2007 e 2018, tendo como base os dados notificados ao SINAN. Testar tendência temporal pelo teste não paramétrico de Cusick. Resultados: Houve queda da taxa de incidência de 1,02 (/100.000 hab.), em 2007, para 0,67, em 2018 (p=0,01). A queda foi significativa em todas as idades, exceto abaixo dos 15 e acima dos 60 anos. As maiores incidências (@1,0/100.000 hab.) ocorreram entre 20 e 59 anos. Conclusão: Há progressivo "envelhecimento" dos casos agudos de hepatite B no país, provavelmente pela proteção dos mais jovens por vacina. Parcela considerável da população mais idosa é suscetível ao HBV e continua exposta, principalmente por via sexual. São necessárias medidas de controle, como vacinação e orientação para prática de sexo seguro.
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Humans , Hepatitis B virus , Acute Disease , Hepatitis B , Vaccination , Disease Transmission, Infectious , InfectionsABSTRACT
Objective@#To investigate the differences in frequency and function of natural killer cells (NK) between chronic hepatitis B (CHB) and acute hepatitis B (AHB).@*Methods@#Patients with AHB and those with CHB in immune active (IA) phase were enrolled. The frequencies of NK, CD56dimNK, CD56brightNK and the expression of functional molecules IFNAR2 and NKp46 on the surface of NK cells were detected respectively among patients with CHB in IA phase, patients with AHB, and those recovered from AHB. At the same time, their correlations with ALT, HBV DNA and HBV markers were analyzed.@*Results@#Between IA and AHB, the frequencies of NK cells and NKp46dim NK cells in AHB cases were significantly lower than those in IA cases, but the frequency of NKp46high NK cells in AHB was higher than that in IA. For patients who recovered from AHB, the frequency of NK cells and NKp46dim NK cells increased; the varied ranges of frequencies of CD56dimNK, IFNAR2+ NK and NKp46+ NK cells were on the rise, while the frequency of NKp46high NK cells decreased after the recovery from AHB, and the varied ranges of CD56brightNK and IFNAR2MFI, NKp46MFI decreased. In AHB, HBVDNA loads were positively correlated with ALT levels. Before and after the recovery of AHB: ΔHBV DNA and ΔALT, Δ NK/LY (%) were positively correlated; ΔALT and ΔNKp46highNK/NK(%), ΔNKp46MFI, ΔIFNAR2MFI were positively correlated.@*Conclusions@#In CHB immune active phase, the activity of peripheral blood NK cells was too weak to remove the virus, but NK cells play an important role in eliminating the viruses and mediating liver tissue inflammation in AHB.
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Objective To understand the characteristics of acute hepatitis B inpatients reported by the hepatitis B surveillance pilot points and to estimate the consistency between the diagnosed and reported types of hepatitis B by the clinicians involved.Methods Data related to acute hepatitis B was from the NNDRS and the characteristics of acute hepatitis B were classified by querying Hospital Information System.We recorded the results based on clinical diagnosis and analyzed the consistency between the reported and diagnosed types that the clinicians made,on hepatitis B.Resulis A total of 179 patients were included in this study with all of them as acute hepatitis B reported through NNDRS in 2015-2016.In terms of the durations of disease,among the 179 cases who were HBsAg positive,32.40％ (58/179) of them exceeding 6 months,2.79％ (5/179) within 6 months and 64.80％ (116/179) tested the first time or never.Among the 179 cases who claimed having the history of hepatitis,33.52％ (60/179) of them identified as having hepatitis B,1.12％ (2/179) were hepatitis A,C or E,41.34％ (74/179) did not have the signs on hepatitis,while the rest 24.02％ (43/179) did not know the situation.Only 79.89％(143/179) of the patients showed the symptoms or signs of hepatitis,but the rest 20.11％(36/179) did not.Among the 179 reported acute hepatitis patients,67 of them were diagnosed as acute hepatitis B while 112 cases were as non-acute hepatitis B.The consistent rate of acute hepatitis B was 37.43％ (67/179).Among the 112 cases that were diagnosed as non-acute hepatitis B,proportions of chronic hepatitis B and cirrhosis were 49.11％(55/112) and 16.07％(18/112) respectively.Conclusion Consistency between the reported type of acute hepatitis B inpatients and the types diagnosed by clinicians was poor.Our results suggested that clinicians should make the accurate diagnosis at first place and then report to the Network in accordance with the clinical diagnosis classification criterfia,set by the government.
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Objective To understand the characteristics of acute hepatitis B inpatients reported by the hepatitis B surveillance pilot points and to estimate the consistency between the diagnosed and reported types of hepatitis B by the clinicians involved.Methods Data related to acute hepatitis B was from the NNDRS and the characteristics of acute hepatitis B were classified by querying Hospital Information System.We recorded the results based on clinical diagnosis and analyzed the consistency between the reported and diagnosed types that the clinicians made,on hepatitis B.Resulis A total of 179 patients were included in this study with all of them as acute hepatitis B reported through NNDRS in 2015-2016.In terms of the durations of disease,among the 179 cases who were HBsAg positive,32.40％ (58/179) of them exceeding 6 months,2.79％ (5/179) within 6 months and 64.80％ (116/179) tested the first time or never.Among the 179 cases who claimed having the history of hepatitis,33.52％ (60/179) of them identified as having hepatitis B,1.12％ (2/179) were hepatitis A,C or E,41.34％ (74/179) did not have the signs on hepatitis,while the rest 24.02％ (43/179) did not know the situation.Only 79.89％(143/179) of the patients showed the symptoms or signs of hepatitis,but the rest 20.11％(36/179) did not.Among the 179 reported acute hepatitis patients,67 of them were diagnosed as acute hepatitis B while 112 cases were as non-acute hepatitis B.The consistent rate of acute hepatitis B was 37.43％ (67/179).Among the 112 cases that were diagnosed as non-acute hepatitis B,proportions of chronic hepatitis B and cirrhosis were 49.11％(55/112) and 16.07％(18/112) respectively.Conclusion Consistency between the reported type of acute hepatitis B inpatients and the types diagnosed by clinicians was poor.Our results suggested that clinicians should make the accurate diagnosis at first place and then report to the Network in accordance with the clinical diagnosis classification criterfia,set by the government.
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Objective@#To investigate the differences in function of plasmacytoid dendritic cells (pDC) and CD4+ T helper cells (CD4+ Th cells) between acute hepatitis B (AHB) and chronic hepatitis B (CHB).@*Methods@#In this study, patients with AHB and those with CHB in immune active (IA) phase were enrolled. The frequencies of pDC, CD86+ pDC, CD4+ T cells and their subsets, surface functional molecules were detected respectively among patients with chronic HBV infection in IA phase, patients with AHB, those recovered from AHB. Meanwhile, their correlations with ALT, HBV DNA and HBV markers were analyzed.@*Results@#The ALT level in AHB was significantly higher than that in IA, and inflammation was more obvious in AHB. Between IA and AHB, CD86+ pDC frequency and the mean fluorescence intensity of functional molecule CD86 (CD86MFI) were higher in IA than those in AHB, but the frequency of CD4+ T cells in AHB was higher than that in IA. For patients who got over AHB, the frequency of CD86+ pDC increased; Th1 were on the rise, while the frequencies of CD4+ T and Th2 decreased after the recovery of AHB, and Th2 / Th1 ratio decreased..In AHB, HBVDNA loads were positively correlated with ALT levels and Th2 frequencies.@*Conclusions@#In CHB immune active phase, CD86+ pDC with stimulating function played an important role, but the cellular immune response of CD4+ T cells decreased. In AHB inflammatory stage, CD4+ T cells played a strong cellular immune response, which result ed in viral clearance. Th2 cells regulation of CD4+ T cells played a dominant role, which was involved in the inflammatory response, and the cytotoxic role of Th1 cells during the recovery period was dominant, playing a strong cellular immune response, then the virus were completely eliminated.
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Objective:To determine the spectrum drift characteristics of CI4+CD25+Tregs TCR β chain CDR3 in patients with different phases of acute hepatitis B (AHB) and chronic hepatitis B (CHB) patients before and after the entecavir treatment.Methods:Anticoagulation venous blood was collected from 4 normal control subjects,3 AHB patients with acute phase and convalescent phase,and 4 CHB patients before and after the entecavir treatment;and peripheral blood mononuclear cells were isolated;CD4+ CD25+ Tregs were separated by using the magnetic beads,and total RNAs were extracted from CD4+ CD25+ Tregs and used for reverse transcription.The TRBV CDR3 was amplified by polymerase chain reaction (PCR) with forward primers specific for 24 TRBV families and one fluorescence-labeled common reverse primer specific for the BC region.The PCR products were sent out for Genescan,and results were analyzed for the TRBV family CDR3 spectrum characteristics by using the Peak Scanner Software vl.0.Data were analyzed with the comparative t-test to perform the statistical analysis.Results:The CDR3 spectral types of the TRBV family showed drift characteristics in 3 cases of AHB patients with acute and convalescent phases;single/oligo peak spectral type family was observed in most of patients with acute phase;multiple peak spectral type was seen in patients with convalescent phase;and the common spectrum shift of TRBV4,10,14,16,19 families seen in patients with acute phase was changed to multiple peak spectral type.The clonal expansion of TRBV family in the CD4+CD25+Tregs in PBMC from AHB patients with convalescent phase was significantly lower than AHB patients with acute phase (t =9.456,P =0.011).The clonal expansion of Tregs TRBV13.2,15,16,18,20 family seen in C HB patients before treatment may interfere the virus removal through down-regulating the body's immune response;and with the decline of viral load in serum after the antiviral treatment,the clonal expansion of Tregs TRBV1,5.2,6,12,14,24 family may help body induce immune tolerance and result in the HBV persistence.The clonal expansion of TRBV family in the CI4+CD25+Tregs in PBMC from of CHB patients after antiviral treatment was increased (t =-0.666,P =0.553).Conclusion:TRBV4,10,14,16,19 family of spectrum shift seen in AHB patients with acute phase was changed to multiple peak spectral type in patients with convalescent phase,suggesting this transition may be associated with HBsAg and HBeAg turning to negative.The clonal expansion of Tregs TRBV13.2,15,16,18,20 family seen in CHB patients before treatment may interfere the virus removal through down-regulating the body's immune response;and with the decline of viral load in serum after the antiviral treatment,the clonal expansion of Tregs TRBV1,5.2,6,12,14,24 family may help body induce immune tolerance and result in the HBV persistence.
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Background: Severe acute hepatitis B (SAHB) is an insufficiently described clinical entity, with relatively scarce data on anti-viral therapy available in field literature. Methods: We performed an open-label study to evaluate specific antiviral therapy in SAHB in Bucharest, Romania, during 2005–2009. Patients were allocated to two treatment groups and one control group: Group 1 – lamivudine 100 mg/day, Group 2 – entecavir 0.5 mg/day and Group 3 – standard of care, without anti-viral therapy. The primary endpoint was hepatitis B surface antigen (HBsAg) to hepatitis B surface antibody (anti-HBs) seroconversion by 24 weeks. Additional analyses included assessment of HBsAg clearance and hepatitis B e antigen (HBeAg) to hepatitis B e antibody (anti-HBe) seroconversion. Results: In Group 1, 7/69 patients (10.14%, P = 0.032) reached HBsAg/Ab seroconversion by 24 weeks, compared with 9/21 (42.85%, P = 0.053) in Group 2 and 25/110 (22.72%) in Group 3. HBsAg clearance by 24 weeks: 16/69 patients (23.18%, P = 0.027) in Group 1, 11/21 (52.38%, P = 0.256) in Group 2 and 43/110 (39.09%) in Group 3. HBeAg/Ab seroconversion: 46/61 (75.40%, P = 0.399) in Group 1, 9/19 (47.36%, P = 0.001) in Group 2 and 74/100 (74.00%) in Group 3. Conclusion: Anti-viral therapy can be considered for managing selected cases of SAHB. Biochemical as well as virological parameters need to orient the choice of the anti-viral agent. Lamivudine displayed a greater decrease in viral load compared to controls, but it was associated with lower levels of HBsAg to anti-HBs seroconversion. Patients treated with entecavir showed a better response in terms of HBs seroconversion by 24 weeks.
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ObjectiveTo investigate the clinical features of acute hepatitis B (AHB) and acute exacerbation of chronic hepatitis B (CHB) for differential diagnosis. MethodsA retrospective analysis was performed on the clinical data of 96 AHB patients and 124 patients with acute exacerbation of CHB, who were admitted to the Public Health Clinical Center Affiliated to Fudan University from June to December, 2014. Comparison of continuous data between the two groups was made by Mann Whitney U test, while comparison of categorical data was made by chi-square test. ResultsThere were no significant differences in the age of onset and sex between the AHB group and the acute exacerbation of CHB group; the incidence was higher in males than in females. Sexual transmission and iatrogenic transmission were the main routes of transmission for AHB, while mother-to-child transmission was the main route of transmission for acute exacerbation of CHB. The sensitivity and specificity of alanine aminotransferase (ALT) level ≥1072 U/L for diagnosing AHB were 78.6% and 79.2%, respectively. The sensitivity and specificity of S/CO ≥13.6 in the anti-HBc-IgM test for diagnosing AHB were 94.5% and 89.3%, respectively. At week 2 after admission, the AHB group showed significantly greater decreases in levels of HBsAg, HBeAg, and hepatitis B virus (HBV) DNA than the acute exacerbation of CHB group (P＜0.05). At week 8 after admission, the AHB group had significantly higher HBsAg clearance rate, anti-HBs seroconversion rate, HBeAg clearance rate, anti-HBe seroconversion rate, and HBV DNA clearance rate than the acute exacerbation of CHB group (P＜0.05). ConclusionIt is helpful for making the differential diagnosis between AHB and acute exacerbation of CHB to know the route of transmission, ALT level, anti-HBc-IgM test result (S/CO value), HBV DNA clearance rate, and the seroconversion rates of HBV markers.
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Background: Hepatitis E is being increasingly recognized as an emerging infection in developed countries. Data on histological findings and nature of inflammatory cell infiltrate in liver in this disease are quite sparse. Aims: This study was planned to study the histological features and the type of inflammatory infiltrate in liver biopsies of patients with acute fulminant hepatitis E. Materials and Methods: We retrieved postmortem liver biopsies of 11 Indian patients with fulminant hepatitis E, and compared these with biopsies from seven patients with fulminant hepatitis B. Results : Biopsies from acute fulminant hepatitis E showed varying degrees of hepatocyte necrosis, mixed portal and lobular inflammation, accompanied by bile ductular proliferation, lymphocytic cholangitis, Kupffer cell prominence, cholestasis, apoptotic bodies, pseudo-rosette formation, steatosis, and presence of plasma cells in portal tracts. Interface hepatitis was more frequent in acute hepatitis B than in acute hepatitis E (100% vs 20%; P<0.05). These findings differ from those reported in cases with autochthonous hepatitis E in Europe. On immunohistochemistry, lymphocyte infiltrate consisted predominantly of CD3 + T cells in both hepatitis E and hepatitis B; these cells contained a predominant cytotoxic (CD8 + ) cell subpopulation in 81.8% of cases with hepatitis E and in 50% of cases with hepatitis B. Conclusion: Our findings suggest that histological changes in HEV infection may vary with geographical location because of prevalent HEV genotypes, and that CD8 + lymphocytes play a role in HEV-induced liver injury.
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Adolescent , Adult , CD3 Complex/analysis , Biopsy , CD8-Positive T-Lymphocytes/immunology , Child , Female , Hepatitis B/pathology , Hepatitis E/pathology , Histocytochemistry , Humans , Immunohistochemistry , Liver/pathology , Male , Microscopy , Middle Aged , Young AdultABSTRACT
Fulminant hepatitis B virus infection occurs in less than 1percent of acutely infected patients. Acute hepatitis Baccounts for 2-42 percent of the total of fulminant hepatitis cases depending on the geographic area. This infection is associated with 65-93 percent of mortality, without liver transplantation. Its pathogenesis is related to a severe immune response to infected hepatocytes, causing massive cytolysis and liver failure. During the last 3 decades its prognosis has improved due to better medical support in intensive care units, the use of liver transplantation and an improvement in the prevention and management of its complications. More recently the use of liver support devices (MARS, Prometheus, and BAL) has been considered in this situation as a bridge to liver transplantation. Recurrent hepatitis B virus reinfection of the graft was a major issue in the past, but currently with the use of hepatitis B immunoglobulin (HBIg) and oral antiviral therapy, the prognosis has improved, leading to excellent graft and patient outcomes after liver transplantation. There is controversial data on the use of oral antiviral therapy among fulminant hepatitis patients. While some authors have shown beneficial effects, other communications have failed to demonstrate any benefits. Nevertheless, many experts currently recommend the use of oral antiviral therapy in this setting due to their relative safety and potential benefits. This paper reviews the current view on management issues in reference to the patient with fulminant hepatic failure due to acute hepatitis B.
La hepatitis fulminante por virus de hepatitis B ocurre en menos del 1 por ciento de los casos de hepatitis B aguda. Del total de hepatitis fulminantes, entre el 2-42 por ciento son causadas por hepatitis B aguda, dependiendo del lugar geográfico donde se estudia. Se asocia a elevada mortalidad, entre 65-93 por ciento, sin el uso de trasplante hepático. Su patogenia se relaciona a una significativa respuesta inmune a hepatocitos infectados, determinando citolisis masiva y falla hepática. En las últimas 3 décadas el pronóstico de esta patología ha mejorado gracias al soporte médico en unidades de tratamiento intensivo, a la implementación del trasplante hepático, y a la mejoría en la prevención y manejo de sus complicaciones. Más recientemente se ha usado dispositivos de soporte hepático (MARS, Prometheus, BAL), como un puente al trasplante hepático. La reinfección del injerto con hepatitis B era una consideración importante en el pasado, pero con el uso de gamaglobulina específica para hepatitis B y el tratamiento antiviral oral, su pronóstico ha mejorado, determinando un excelente pronóstico del injerto y del paciente a largo plazo post trasplante hepático. Existen datos controversiales referentes al uso de antivirales orales durante una hepatitis fulminante, pues algunos autores muestran beneficios en esta condición, pero otros no han demostrado un beneficio real. Sin embargo, muchos expertos actualmente recomiendan su uso en este escenario, pues son seguros y pueden tener un potencial beneficio. Este artículo revisa el manejo actual del paciente con hepatitis fulminante por hepatitis B aguda.
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Humans , Liver Failure, Acute/surgery , Liver Failure, Acute/etiology , Liver Failure, Acute/drug therapy , Hepatitis B/complications , Acetylcysteine/therapeutic use , Antiviral Agents/therapeutic use , Risk Factors , Liver Failure, Acute/epidemiology , Liver Failure, Acute/pathology , Prognosis , Liver Transplantation , Hepatitis B virus , Severity of Illness IndexABSTRACT
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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
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Adult , Female , Humans , Male , Middle Aged , Acute Disease , Alanine Transaminase/blood , Antiviral Agents/therapeutic use , Aspartate Aminotransferases/blood , Bilirubin/blood , DNA, Viral/analysis , Hepatitis B/diagnosis , Hepatitis B Antibodies/blood , Hepatitis B e Antigens/blood , Retrospective StudiesABSTRACT
Objective:To conduct a clinical tretrospective study on the effect of Silymarin Meglumine Tab on acute and chronic hepatitis B and to explore the related clinical significance. Methods: 41 cases and 205 cases of hospitalized patients pathologically diagnosed as acute and chronic hepatitis B respectively by liver tissuse puncture were divided into three group: ① Silymarin Meglumine Tab group; ② Ganyanling group; ③ complex group consisting of Silymarin Meglumine Tab and Gangyanling and diammonium glycyrrhizinate. To detect the index of routine liver function test before and after the treatment and analyze the hospitalization treatment course. Results: Compared with before treatment, liver functions of acute and chronic hapatitis B were improved to certain extent within each group after treatment (P0.05). The hospitalization treatment time of acute hepatitis B of the three group were almost the same, but the hospitalization treatmeng time of chronic hepatitis B of the Silymarin Meglumine Tab group was 2-4days less than that of the Ganyanling group and the complex group. Conclusion: As far as Silybini Meglumine Tab was concerned, it was better for chronic hepatitis B than acute hepatitis B because it was less complicated to administer the medicine, relieving the liver's burden of metabolism, and hospitalization treatment time was shorter, relieving patients' financial burden,which suggested that it was important to administer proper amount of medicine while taking into consideration protecting the liver's compensation function. If consideration was given to stimulating liver microcirculation with small dosage of TCM, so as to promote the exchange of the liver metabolite in blood, or detoxication and expulsion of toxin, it was likely to be more advantageous to the restoration of liver function and the liver tissue structure.
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19 patients (male: 17) with ages of 16-56 in the Institute of Clinical Medicine and Tropical Diseases participated to a study whose blood samples were measured the concentration of tumor necrosis factor - alpha (TNF-alpha), biochemical and hematological, immunological parameters. The results have shown that there was a high increase of TNF-alpha in patients with acute hepatitis B comparing with this in normal people. There was a correlation between the TNF-alpha and SGOT within the first 2-3 months of disease. There was a correlation between TNF-alpha and SGPT in the second months of disease. There was indirect proportional between the TNF-alpha and serum total bilirubine in the second months of disease.
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Hepatitis , Tumor Necrosis Factor-alpha , NecrosisABSTRACT
A stable, liver disease-free cohort of 369,725 was reconstructed as of 1984 for the study of hepatitis B virus seromarkers and liver diseases. The cohort consisted of male beneficiaries of the Korea Medical Insurance Corporation (KMIC) over 30 years of age and living nationwide. Subjects who were both negatives for HBsAg and anti-HBs (N = 274,037) were selected for incidence of hepatitis B. Data on test results of HBsAg and anti-HBs in 1984 and on hepatitis B occurrence during 1985-1986 were collected from the files of the KMIC. Linkage was done between these two data sets to measure the incidence rate through a longitudinal observation of the male population. Correction against misclassification error and duplicate claims was done by a sample survey and verification procedures. The incidence rate of hepatitis B was 17.13 per 100,000 person-years for acute viral hepatitis B and 15.74 for chronic hepatitis B, respectively. An increasing age-dependent pattern for acute hepatitis B was not so prominent in this population. However, the incidence rate of chronic hepatitis B steadily increased with age. The relative risk, estimated by a log-linear model for rate and constant hazard, was significantly higher in the over-60 age group than in the others. The incidence rate in the lower socioeconomic class was higher than in the others, although statistically not significant.