Clinical Features Of HBeAg-negative Chronic Hepatitis B Patients

Background:In recent years,the prevalence of HBeAg-negative chronic HBV-related liver disease has increased gradually in many countries, according to many studies. It has been confimed that part of HBeAg-negative chronic hepatitis B patients had higher mortality rate and higher hepatocellular carcinoma incidence rate than HBeAg-positive counterpart.Objective:Through the retrospective study to invesgate the prevalence of HBeAg-negative chronic HBV-related liver disease in the First Affiliated Hospital of Kunming Medical University from2008to2012, and compare the HBeAg-negative chronic hepatitis B with the HBeAg-positive chronic hepatitis B patients in the serum level of HBV-DNA,patient’s condition and diagnosis,liver function and the basic information of demography.In order to determine the the local prevalence of HBeAg-negative chronic hepatitis B further and provide clinical reference for establishment of proper prevention and treatment strategy of the HBeAg-negative chronic hepatitis B patients and subsequently epidemic investigation.Methods:collecting data about3035chronic hepatitis B patients who were hospitalized in the infectious disease department from2008to2012in the First Affiliated Hospital of Kunming Medical University. All of the patients were detected the clinical features,the results of liver function-. HBV-DNA quantification data and serum hepatitis viral markers for the first time after hospitalization Statistics analysis was performed using SPSS19.0.Results::1、Among the3035patients,1593(52.5%)were HBeAg-negative CHB patients and1442(47.5%)were HBeAg-positive CHB patients.The prevalence of HBeAg-negative chronic HBV-related liver disease in the First Affiliated Hospital of Kunming Medical University in2012was53.1%, significantly higher than51.0%of2008.2> The average age of HBeAg-negative CHB patients was older than that of HBeAg-positive CHB patients (46.22±13.48岁VS37.95±13.07岁, P=0.01) HBeAg-negative CHB patients had significantly lower ALT\ALB and HBV-DNA level than HBeAg-positive CHB patients (80U/LVS97U/L,34.21±7.38g/L VS35.88±7.76g/L,5.06±1.23VS6.36±1.22, P=0.01). HBeAg-negative CHB patients had significantly higher TB level than HBeAg-positive CHB patients (27umol/L VS34umol/L, P=0.000). There was positive correlation between Age, HBV DNA level,ALT,TBand ALB level in HBeAg-negative CHB patients. There was no correlation between AST (P=0.45)3、There was positive correlation between HBV-DNA level and ALT and AST level in HBeAg-negative CHB patients(P=0.000). There was no correlation between HBV-DNA level and ALT and AST level in HBeAg-positive CHB patients(P=0.979、P=0.228).4、The average age of HBeAg-negative CHB patients with low level replication was older than that of HBeAg-positive CHB patients (46.74±13.46岁VS42.03±11.73岁, P<0.05). HBeAg-negative CHB patients with low level replication had significantly lower ALT and AST level, significantly higher ALB level than those in the HBeAg-positive CHB counterpart.5、The average age of HBeAg-negative CHB patients with high level replication was older than that of HBeAg-positive CHB patients (45.69±13.48岁VS37.20±13.17#, P<0.05). HBeAg-negative CHB patients with high level replication had significantly higher TB level, significantly lower ALB level than those in the HBeAg-positive CHB counterpart.6^The prevalence rate of severe liver disease,cirrhosis in HBeAg-negative group were higher than HBeAg-positive group (13.7%VS10.5%,37.4%VS27.0%).The prevalence rate of HCC in HBeAg-negative group were higher than HBeAg-positive group(10.3%VS3.9%),The prevalence rate of chronic hepatitis B in HBeAg-positive group were higher than HBeAg-negative group (58.7%VS38.6%) Conclusions:1、The prevalence of HBeAg-negative chronic HBV-related liver disease in the First Affiliated Hospital of Kunming Medical University increased gradually from51.0%in2008to53.7%in2012.2、HBeAg-negative CHB patients had different clinical features from HBeAg-positive CHB patients, suggesting different outcomes because of mutation.3、HBeAg-negative CHB patients with low level replication had lighter liver damage than HBeAg-positive counterpart. HBeAg-negative CHB patients with high level replication had more severe liver damage than HBeAg-positive counterpart.4、The prevalence rate of severe liver disease,cirrhosis and HCC in HBeAg-negative group were higher than HBeAg-positive group. The prevalence rate of chronic hepatitis B in HBeAg-positive group were higher than HBeAg-negative group.