Objective To investigate the factors related to negative conversion of HBsAg in patients with acute hepatitis B (AHB) . Methods A total of 106 AHB patients who were admitted to the Department of Infectious Diseases, Zhoukou Central Hospital from February 2007 to February 2013 were recruited. Liver function, five serological markers of HBV infection (HBsAg, HBeAg, anti- HBs, anti- HBe, and anti- HBc) , and HBV- DNA were measured every three months. All patients were followed up for 12 months. The major HBV genotypes (A through D) were determined by type-specific primer nested PCR. Categorical data were expressed as rates and compared with χ2test;continuous data were expressed as mean ± SD and analyzed by t- test. Results When just admitted to our hospital, compared with the patients with negative conversion of HBsAg, AHB patients with HBsAg persisting for more than 6 or 12 months had a significantly lower peak level of alanine aminotransferase (ALT) (718 ± 696 vs 1282 ± 913 U /L, 622 ± 514 vs 1203 ± 924 U /L, P < 0. 05) and a significantly higher level of HBV- DNA (6. 8 ± 1. 4 vs 5. 2 ± 1. 5 log10 copies /ml, 7. 3 ± 1. 6 vs 5. 4 ± 1. 5 log10 copies /ml, P < 0. 05) . The HBsAg clearance rate in patients with HBV genotype A was significantly lower than that in patients with HBV genotype B or D (75. 0% vs 89. 5% or100%, 83. 3% vs 97. 4% or 100%, P < 0. 05) . Conclusion The HBsAg clearance rate in AHB patients may be associated with HBV genotypes, peak level of ALT, and HBV- DNA.
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