Analysis of the factors related to the changes of liver pathology in HBeAg negative chronic hepatitis B patients / 中华传染病杂志

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(rO.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.