Correlation between the spontaneous clearance of HBV DNA and the levels of alanine aminotransferase in chronic hepatitis B / 中华肝脏病杂志

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the correlation between spontaneous clearance of HBV DNA and the levels of Alanine Aminotransferase (ALT) in chronic hepatitis B (CHB) patients.</p><p><b>METHODS</b>Retrospective review analysis was used in this research. A total of 177 CHB patients with HBV DNA>1x10(4) copies/ml and ALT>800 U/L were recruited in this study and were divided randomly into two groups, 84 patients in control group (received lamivudine therapy) while 96 cases in study group (without anti-viral therapy), the dynamic changes of HBV DNA and HBV markers in these two groups were compared.</p><p><b>RESULTS</b>The clinical data of CHB patients were retrospected and followed up in 24 weeks. The negative conversion cases of HBV DNA are 62 (87.3%) in study group and 56 cases (78.87%) in control group at week 24, the negative conversion cases of HBV DNA are 56 (78.9%) in study group and 60 (92.3%) cases in control at week 8. No significant difference (x2=0.058, P>0.05) existed between these two groups. Among 43 patients with HBV DNA is less than or equal to 6 log10 copies/ml, 41 (95.3%) patients converted negatively, while in 28 patients with HBV DNA is more than 6 log10 copies/ml, 21 (75.0%) patients converted negatively. The negative conversion rate of HBV DNA is more than 6 log10 copies/ml was lower than the other group at week 24. The difference between the two groups was significant (x2=0.024, P<0.05). 41 patients with hepatitis B e antigen (HBeAg) negative and 30 patients with HBeAg positive were included in antiviral group. The negative conversion cases of HBV DNA of the former are 36 (87.8%) and the latter are 26 (86.7%). No significant difference found between them (x2=1, P>0.05). HBeAg loss found in 10 patients of 30 HBeAg positive patients with 4 patients occurred as early as at the fourth week. A total of 62 patients HBV DNA converted negatively in antiviral group, but 5 patients were found HBV DNA rebounded (occurred in 24 to 72 weeks) with ALT rebound (47 to 140 U/L).</p><p><b>CONCLUSIONS</b>The tendency of spontaneous clearance of HBV DNA when ALT is more than 800 U/L is obvious, so anti-viral therapy should be administrated strictly. The negative conversion rate of HBV DNA has no relation with HBeAg but with the copies of HBV DNA replication.</p>