title: Age versus clinical virological characteristics in chronic hepatitis B virus infection:  a case series study in China.
abstract: OBJECTIVE
  This study aimed to investigate the clinical virological characteristics of hepatitis B virus (HBV) in chronic HBV infection patients of different ages, especially in relapse patients and patients with immune clearance.
  
  
  METHODS
  The HBV clinical virological characteristics of chronic HBV infection were investigated in 1572 Chinese patients of different age groups (<20, 20-40, and >40 years old).
  
  
  RESULTS
  Of the patients in the below 20 age group, those with evidence of immune tolerance accounted for 86.05% (P<0.001). Of the patients in the 20-40 age group, those with immune clearance accounted for 36.36% (P<0.001). Of the patients in the above 40 age group, there were markedly more reactivation cases than in any other group (P<0.001). Our data indicated that a positive correlation (r=0.480, P<0.001) existed between HBV DNA contents (on a log10 scale) and the alanine aminotransferase (ALT) level of the total cases with reactivation. Of the 300 cases with immune clearance being followed up 10-50 months after enrollment, 181 cases achieved spontaneous hepatitis B e antigen (HBeAg) seroconversion (HBeAg to anti-HBe), and the younger the patient, the shorter the time to seroconversion (P<0.05).
  
  
  CONCLUSIONS
  Generally, there were significantly different HBV clinical virological characteristics in patients with chronic HBV infection of different ages. Different features were observed in relapse patients and patients with immune clearance at different ages, and these two types of patients needed antiretroviral therapy. Our study suggests that revisions of the timing and elevated alanine aminotransferase standards for chronic hepatitis B antiretroviral therapy in Chinese relapse patients and patients with immune clearance in different age groups are warranted.
authors.affiliation: Department of Genetics and Molecular Biology, School of Medicine, Xi'an Jiaotong University, Xi'an, China.
authors.forename: Dian-Lei
authors.initials: DL
authors.lastname: Wu
authors.forename: Guang-Hua
authors.initials: GH
authors.lastname: Xu
authors.forename: She-Min
authors.initials: SM
authors.lastname: Lu
authors.forename: Bo-Lin
authors.initials: BL
authors.lastname: Ma
authors.forename: Nai-Zhou
authors.initials: NZ
authors.lastname: Miao
authors.forename: Xiao-Bin
authors.initials: XB
authors.lastname: Liu
authors.forename: Ji-Hong
authors.initials: JH
authors.lastname: Feng
authors.forename: Na
authors.initials: N
authors.lastname: Liu
authors.forename: Qing-Lei
authors.initials: QL
authors.lastname: Zeng
authors.forename: Wei-Kun
authors.initials: WK
authors.lastname: Hou
authors.forename: Lei
authors.initials: L
authors.lastname: Pei
authors.forename: Yingren
authors.initials: Y
authors.lastname: Zhao
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000410:Alanine Transaminase / Q000097:blood; D015415:Biomarkers / Q000097:blood; D004279:DNA, Viral / Q000097:blood; D005260:Female; D005838:Genotype; D006510:Hepatitis B Antibodies / Q000097:blood; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology; D019694:Hepatitis B, Chronic / Q000000981:diagnostic imaging / Q000276:immunology / Q000821:virology*; D006801:Humans; D007108:Immune Tolerance; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012737:Sex Factors; D013997:Time Factors; D014463:Ultrasonography; D019562:Viral Load; D014775:Virus Activation / Q000502:physiology; D014779:Virus Replication / Q000502:physiology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006513:Hepatitis B e Antigens; D000410:Alanine Transaminase