title: Determinants for the occurrence of acute exacerbation of hepatitis B virus infection in Chinese patients after HBeAg seroclearance.
abstract: This study was performed to determine the factors for predicting the occurrence of acute exacerbation of hepatitis B virus infection in HBeAg-negative patients. Two hundred and sixteen patients with known times of HBeAg seroclearance were recruited. Liver biochemistry and virologic markers were monitored. Precore and core promoter mutations were determined by a line probe assay. The median age at HBeAg seroclearance was 34.5 years. The median follow-up duration was 26.4 months. Fifty-six (27.9%) patients had acute exacerbations. By Cox regression analysis, male gender, older age, and core promoter mutations at the time of HBeAg seroclearance were independently associated with the occurrence of acute exacerbation after HBeAg seroclearance (P = 0.025, 0.018, and 0.001, respectively). Fourteen (7.0%) patients had HBeAg seroreversion within a median follow-up period of 11.6 months after HBeAg seroclearance. By Cox regression analysis, older age at HBeAg seroclearance was independently associated with the chance of HBeAg seroreversion (P = 0.01). We concluded that male patients with core promoter mutations and delayed HBeAg seroclearance had a higher cumulative chance of acute exacerbation in the HBeAg-negative phase. Patients with delayed HBeAg seroclearance had a higher frequency of HBeAg seroreversion.
authors.affiliation: Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam Rd., Hong Kong, China.
authors.forename: He-Jun
authors.initials: HJ
authors.lastname: Yuan
authors.forename: Man-Fung
authors.initials: MF
authors.lastname: Yuen
authors.forename: Danny Ka-Ho
authors.initials: DK
authors.lastname: Wong
authors.forename: Siu-Man
authors.initials: SM
authors.lastname: Sum
authors.forename: Joke
authors.initials: J
authors.lastname: Doutreloigne
authors.forename: Erwin
authors.initials: E
authors.lastname: Sablon
authors.forename: Ching-Lung
authors.initials: CL
authors.lastname: Lai
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006512:Hepatitis B Core Antigens / Q000235:genetics; D006513:Hepatitis B e Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity*; D019694:Hepatitis B, Chronic / Q000503:physiopathology* / Q000821:virology; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011237:Predictive Value of Tests; D011401:Promoter Regions, Genetic; D011498:Protein Precursors / Q000235:genetics
chemical_list: D004279:DNA, Viral; D006512:Hepatitis B Core Antigens; D006513:Hepatitis B e Antigens; D011498:Protein Precursors