The Clinical Feature Of The Patients With HBeAg-negative Chronic Hepatitis B

Objective:11909 patients with chronic hepatitis B were registered in this study,of which 9985 were outpatients and 1924 patients were hospitalized.Through the retrospective study for investigating the ration of the patients with HBeAg- negative, several indexes were compared in these patients with HBeAg-negative and HBeAg-positive,including the HBV-DNA in serum,the frequency of viral mutation, patient's condition and diagnosis,liver function and the basic information of demography.To determine the local prevalence characters of hepatitis B patients with the HBeAg-negative further,it can provide reference data for establishment of proper prevention and treatment strategy of the HBeAg-negative hepatitis B patients and subsequently epidemic investigation.Methods:Collecting data about 11909 patients with chronic hepatitis B(9985 outpatients from 2004 to 2007 and 1924 hospitalized individuals from 2003 to 2007) in the infectious disease department,the first affiliated hospital of Kunming Medical College.All the hospitalized patients had the results of liver function and serum hepatitis B viral markers that were tested by ELISA assay.According to the HBeAg status,these patients were divided into two groups.Groupâ… :HBsAg,HBeAg and HBcAb were all positive;Groupâ…¡:HBsAg and HBcAb were both positive,while HBeAg was negative.The groupâ…¡was divided into two subgroups.â…¡A:HBsAg,HBeAb and HBeAb were all positive,while HBeAg was negative.â…¡B:HBsAg and HBcAb were both positive,while HBeAg and HBeAb were negative.The serum HBV-DNA levels of all the patients were quantitated by using real-time fluorescent light quantitative-PCR assay.The pre-C area 1896 code and YMDD were analyzed by PCR-Hybirdization assay.All of the results were statistically analyzed finally.Results:Among the 9985 outpatients,6379(63.89%)were the HBeAg-negative hepatitis B patients and 3606(36.11%)were the HBeAg-positive hepatitis B patients. The ration of the HBeAg-negative hepatitis B patients was higher than the HBeAgpositive hepatitis B patients.The average ages of the HBeAg-negative hepatitis B patients were elder than those with the HBeAg-positive hepatitis B.6614(66.24%) were the male,3371(33.76%)were the female.The number of male was more than the female.The serum HBVDNA levels of HBeAg-negative group were lower than HBeAg-positive group when the serum HBVDNA levels were more than 10~4cp/ml. Of the 1924 patients with chronic hepatitis B,1218 were HBeAg-negative(63.31%), 706 were HBeAg-positive(36.69%).The average ages of the patients with HBeAg-negative chronic hepatitis B were elder than those with HBeAg-positive chronic hepatitis B.The male counted for a predominant number in this group.The prevalence rate of low-grade chronic viral hepatitis and middle chronic viral hepatitis in HBeAg-positive group was higher,compare with HBeAg-negative group.The prevalence rate of cirrhosis and HCC in HBeAg-negative group was higher than HBeAg-positive group.The serum HBVDNA levels of HBeAg-negative group were lower than HBeAg-positive group.As a whole,the TBil levels of HBeAg-negative group was higher compare with HBeAg-positive group,but the ALT,AST and ALB levels were lower.The prevalence rate of pre-core G1896A mutations had no significant difference between the HBeAg-negative group and the HBeAg-positive group.The prevalence rate of YMDD mutations in LAM used group was higher than that had no therapy of LAM.The prevalence rate of the HBeAg-negative patients in interferon regular used group was higher than irregular used group.The prevalence rate of HBeAg had no significant difference among the others.Conclusions:1.The ration of HBeAg-negative hepatitis B patients were higher than that of the HBeAg-positive patients and it was rising year by year.The average ages of the HBeAg-negative hepatitis B patients were elder than those with the HBeAg- positive. The male were more than the female.The serum HBV-DNA levels of HBeAg-negative group were lower than HBeAg-positive group.2.The prevalence rate of low-grade chronic viral hepatitis B and middle chronic viral hepatitis B in HBeAg-positive group was higher,compare with HBeAg-negative group.The prevalence rate of cirrhosis and HCC in HBeAg-negative group was higher than HBeAg-positive group.3.The TBil levels of HBeAg-negative group were higher compare with HBeAg-positive group.The ALT,AST and ALB levels of HBeAg-negative group were lower.4.The prevalence rate of pre-core G1896A mutations had no significant difference between the HBeAg-negative group and the HBeAg-positive group.In different condition,the prevalence rate of pre-core G1896A mutations was about same.5.The prevalence rate of YMDD mutations in lamivudine used group was higher than that had no therapy of lamivudine.6.The prevalence rate of the HBeAg-negative patients in interferon regular used group was higher than irregular used group.The prevalence rate of HBeAg had no significant difference among the others.