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.
[1]MAST EE, ALTER MJ, MARGOLIS HS.Strategies to prevent and control hepatitis B and C virus infections:a global perspective[J].Vaccine, 1999, 17 (13-14) :1730-1733.
|
[2]KURUZM Z, OZGENCO, HAVUK A, et al.Rate of chronicity and time of disappearance of HBsAg following acute hepatitis B[J].Hepatogastroenterology, 2009, 56 (90) :466-469.
|
[3]ZHANG H, LI YT, YIN JH, et al.Risk factors for acute hepatitis B and its progression to chronic hepatitis in Shanghai, China[J].Gut, 2008, 57 (12) :1713-1720.
|
[4]Chinese Society of Infectious Disease and Parasitology, Chinese Society of Hepatology.Management scheme of diagnostic and therapy criteria of viral hepatitis[J].Chin J Hepatol, 2000, 8 (6) :324-329. (in Chinese) 中华医学会传染病与寄生虫病学分会、肝病学分会.病毒性肝炎防治方案[J].中华肝脏病杂志, 2000, 8 (6) :324-329.
|
[5]JIN H, WANG J, ZHUANG H, et al.Evaluation of two type-specific primers PCR genotyping methods of hepatitis B virus[J].Chin J Microbiol Immunol, 2009, 29 (11) :1042-1048. (in Chinese) 金晖, 王杰, 庄辉, 等.两种型特异性引物聚合酶链反应法检测乙型肝炎病毒基因型和亚型的评价[J].中华微生物学和免疫学杂志, 2009, 29 (11) :1042-1048.
|
[6]COLIN JF, CAZALS-HATEM D, LORIOT MA, et al.Influence of human immunodeficiency virus infection on chronic hepatitis B in homosexual men[J].Hepatology, 1999, 29 (4) :1306-1310.
|
[7]BOCHAROV G, LUDEWIG B, BERTOLETTI A, et al.Underwhelming the immune response:effect of slow virus growth on CD81-T-lymphocyte responses[J].J Virol, 2004, 78 (5) :2247-2254.
|
[8]ITO K, YOTSUYANAGI H, YATSUHASHI H, et al.Risk factors for long-term persistence of serum hepatitis B surface antigen following acute hepatitis B virus infection in Japanese adults[J].Hepatology, 2014, 59 (1) :89-97.
|
[9]ZENG G, WANG Z, WEN S, et al.Geographic distribution, virologic and clinical characteristics of hepatitis B virus genotypes in China[J].J Viral Hepat, 2005, 12 (6) :609-617.
|
[10]NAITO H, HAYASHI S, ABE K.Rapid and specific genotyping system for hepatitis B virus corresponding to six major genotypes by PCR using type-specific primers[J].J Clin Microbiol, 2001, 39 (1) :362-364.
|
[11] KURBANOV F, TANAKA Y, MIZOKAMI M.Geographical and genetic diversity of the human hepatitis B virus[J].Hepatol Res, 2010, 40 (1) :14-30.
|