The clinical features of chronic severe hepatitis B with negative hepatitis B e-antigen and positive hepatitis B e-antigen.

Objective To study the clinical features of chronic severe hepatitis B with negative hepatitis B e-antigen(HBeAg)and positive hepatitis B e-antigen(HBeAg).Methods A total of 353 in-patients with chronic severe hepatitis B from the second affiliated hospital of Chongqing Medical University were recruited into the study and divided into two groups according to the HBeAg status.Of the 353 in-patients,236(66.8%)patients were HBeAg-negative,117(33.2%)patients were HBeAg-positive.The average age of HBeAg-negative patients was older than that of HBeAg-positive patients[(43.5±12.4)y and(40.8±11.3)y respectively,P=0.048].The serological chemistry data,hepatitis B virus(HBV)DNA quantification data were detected,and morbility of cirrhosis,its complications and prognosis were also studied.Results The serum HBV DNA level of HBeAg-negative patients was significantly lower than that of HBeAg-positive patients [(5.49±2.02)log10 copies/mL vs(6.64±1.41)log10 copies/mL,P0.01].The ratio of patients who had a serum HBV DNA level less than 5 log10 copies/mL in HBeAg-negative patients was significantly higher than that in HBeAg-positive patients(41.8% vs 11.9%,P0.001).There was no significant difference in serological chemistry data,morbility of cirrhosis and its complications on infections,ascites,hepatoencephalopathy,gastrointestinal hemorrhage,as well as prognosis of the patients between those two groups.Conclusion This study suggested that serological chemistry data,morbility of complications and prognosis of the disease of HBeAg-negative patients resemble those of HBeAg-positive patients.The HBeAg-negative patients had a higher level of age,while a lower level of serum HBV DNA.To reduce the incidence of liver failure,more frequent monitoring and earlier antiviral therapy prone to be reasonable for chronic hepatitis B patients with negative hepatitis B e-antigen(HBeAg).