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Clinical and histological characteristics of chronic hepatitis B with negative hepatitis B e-antigen
Jie Peng1, Kangxian Luo, Youfu Zhu
1Department of Infectious Diseases, Nanfang Hospital, First Military Medical University, Guangzhou 510515, China.
Insights
Chronic hepatitis B (CHB) patients negative for hepatitis B e-antigen (HBeAg) show distinct clinical and histological features. These HBeAg-negative cases exhibit more severe liver inflammation and fibrosis despite lower HBV DNA levels compared to HBeAg-positive patients.
Area of Science:
- Hepatology
- Virology
- Gastroenterology
Background:
- Chronic hepatitis B (CHB) is a significant global health concern.
- Hepatitis B e-antigen (HBeAg) status is a key factor in CHB disease progression.
- Understanding HBeAg-negative CHB is crucial for effective management.
Purpose of the Study:
- To investigate the clinical and histological characteristics of CHB patients with negative HBeAg.
- To compare these features with HBeAg-positive CHB patients.
- To elucidate the relationship between viral load and liver damage in different HBeAg groups.
Main Methods:
- A cohort of 743 in-patients with CHB was analyzed.
- Patients were stratified into HBeAg-negative and HBeAg-positive groups.
- Correlations between alanine transaminase (ALT) levels, HBV DNA quantification, and liver histology (inflammation and fibrosis scores) were assessed.
Main Results:
- HBeAg-negative CHB patients (35.9%) presented with significantly lower HBV DNA levels.
- Despite lower viral loads, HBeAg-negative patients showed more severe liver inflammation (58.1% vs 46.0%) and fibrosis (45.3% vs 27.9%) compared to HBeAg-positive patients.
- In HBeAg-positive patients, ALT levels correlated with histology, but this association was absent in HBeAg-negative cases, indicating distinct disease mechanisms.
Conclusions:
- HBeAg-negative CHB represents a distinct clinical and histological subpopulation.
- Management strategies may need to be tailored based on HBeAg status.
- Further research into the pathogenesis of HBeAg-negative CHB is warranted.
Objective:
To study the clinical and histological features of chronic hepatitis B (CHB) with negative hepatitis B e-antigen (HBeAg).
Methods:
A total of 743 in-patients with chronic hepatitis B were recruited into the study and divided into two groups according to the HBeAg status. The correlation among alanine transaminase (ALT) levels, hepatitis B virus (HBV) DNA semiquantification, and the liver histopathological data were detected.
Results:
Of the 743 successive in-patients, 267 (35.9%) were HBeAg-negative. The HBDAG-negative group had significantly lower serologic HBV DNA levels (63.0% of < 100 pg/ml) vs HBeAg-positive (42.6%, P < 0.001), while more sever inflammation (58.1% of inflammatory scores of histological activity index (HAIinf > or = 9) vs HBeAg-positive group (46.0%, P < 0.001) and severe fibrosis (45.3% of fibrosis scores of histological activity index (HAIfib > or = 3) vs HBeAg-positive group (27.9%, P < 0.001) of liver histology. In HBeAg-positive patients, increasing ALI levels were significantly associated with high inflammation and fibrosis scores and low HBV DNA levels. However, it was not the case in the HBeAg-negative cases. In HBeAg-positive patients, 91.3% of them had HAIinf > or = 9 and 65.7% had HAIfib > or = 3 with HBV DNA > 100 pg/ml, while 8.2% of them had HAIinf > or = 9 and 12.3% had HAIfib > or = 3 with HBV DNA < 20 pg/ml, indicating an obverse correlation between HBV DNA levels and histology scores.
Conclusions:
As regards clinical and histological background, the chronic HBeAg-negative hepatitis B is a different subpopulation from the HBeAg-positive counterpart.
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