基因C型乙肝病毒致乙型肝炎激活并进展为肝硬化风险高于基因B型:一项转氨酶正常的HBe抗原阳性乙型肝炎的纵向调查研究
Genotype C hepatitis B virus infection is associated with a higher risk of reactivation of hepatitis B and progression to cirrhosis than genotype B: A longitudinal study of hepatitis B e antigen- positive patients with normal aminotransferase levels at ba出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)
年 卷 期：2005年第1卷第12期
页 面：47-48页
学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 100401[医学-流行病与卫生统计学] 10[医学]
主 题：乙型肝炎 HBe抗原 乙肝病毒 纵向调查 血清转换 病毒学标志物 发病年龄 无显著性差异 风险因子 多变量分析
摘 要：Background/Aims: Longitudinal studies on the relationship between hepatitis B virus (HBV) genotypes and reactivation of hepatitis B and progression to cirrhosis were very rare. Methods: Liver biochemistry, virological markers and ultrasound were monitored in 202 hepatitis B e antigen (HBeAg)positive patients with normal alanine aminotransferase (ALT) at baseline for 3- 20 (average 10.8) years, and the outcome was correlated with HBV genotypes. Results: There were 150 genotype B and 52 genotype C patients. Hepatitis activity during the HBeAg- positive phase showed no significant difference. However, genotype B was associated with a significantly earlier and higher rate of HBeAg seroconversion. HBeAg seroconversion correlated with age at entry for genotype B and with ALT levels for genotype C. Reactivation of hepatitis B was significantly more common in genotype C patients. Five genotype B and 10 genotype C patients progressed to cirrhosis. Multivariate analysis revealed that genotype C (P=0.03) and reactivation of hepatitis B (P=0.0004) were independent factor predictive of cirrhosis. Conclusions: Rate and factors of HBeAg seroconversion, and rate of reactivation of hepatitis B differed between genotype B and genotype C patients. Genotype C and reactivation of hepatitis B were associated with increased risk of cirrhosis.
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