Analysis The Relationship Between High Level Of ALT In Chronic Hepatitis B And Initiative Negative Of HBVDNA

Objective:To analysis the HBV DNA initiatively turn negative in patients with chronic hepatitis B (ALT> 1000IU/L) in order to study the phenomenon of natural clearance in the CHB patients with ALT at a high level to determine whether some patients required anti-virus treatment and provide a reference at the best time of antiretroviral therapy.Methods:Patients with CHB of out-patient and hospitalization were collected from the department of infectious diseases, the First Affiliated Hospital of Anhui Medical University from January 2005 to June 2008; who was consistent with the condition:①ALT> 1000IU / L, HBVDHA> 1×104copies/ml;②not using anti-virus or immunomodulatory drugs;③all patients should be excluded the infection with other hepatitis virus and other damage of liver. HBVDNA and five target hepatitis B (HBV-M) were follow-up by communicating with patients by telephone and out-patient. The shortest period of follow-up was 24 weeks, the longest was 156 weeks.Results:The 28 cases finished follow-up, HBVDNA (23/28, 82.14%) of 23 cases turned negative within 24 weeks, one of 4 weeks, negative 11 cases (11/28, 39.29%), 8 cases of conversion in paragraph (8 / 28, 28.57%) from 4 to 8 weeks, 3 cases (3 / 28, 10.71%) were conversion from 8 to 12 weeks, 1 case (1 / 28 , 3.57%) was conversion from 12 to 24 weeks. 12 cases with HBeAg-positive, 24 weeks, 9 cases occurred in HBeAg negative (9 / 12, 74%), 3 cases (3 / 12, 25%) occurred serum conversion of HBeAg. 16 cases with HBeAg-negative, 14 people HBVDNA negative, negative rate of 87.5% within 24 weeks. Discussion:The patients of CHB with ALT> 1000IU / L were spontaneous high clearance rate of HBVDNA; ALT showed a high level body to clear the virus more capacity. Spontaneous clearance of virus occurred within 8 weeks. Patients with ALT> 1000IU / L would be able to consider the anti-viral treatment in order to alleviate the financial burden and save resource of health care, and avoid the anti-viral drugs causing adverse effects in patients. Then antiviral therapy may be considered more reasonable when the spontaneous clearance of virus were not clearance within 8 weeks.