title: [Analysis of liver damage and reactivation of hepatitis B virus in hepatitis B surface antigen positive patients after extremely severe burn injury].
abstract: OBJECTIVE
  To analyze the development of liver damage and reactivation of hepatitis B virus (HBV) during the treatment of extremely severe burn injury in HBsAg positive patients, in order to provide reference for prevention and treatment of liver damage in patients with HBV infection after extremely severe burn.
  
  
  METHODS
  Medical records of 54 HBsAg positive patients after extremely severe burn injury admitted from January 2004 to December 2014 were retrospectively analyzed. Development of liver damage and HBV reactivation of these patients during the treatment were analyzed according to the classification of their gender, results of hepatitis B e antigen (HBeAg) and HBV DNA examinations on admission, and development of sepsis in the process of treatment. Data were processed with chi-square test.
  
  
  RESULTS
  (1) The incidence of liver damage in the process of treatment of these patients was 85.2% (46/54). Among all the patients, the proportion of liver damage was 35/38 in male, which was significantly higher than that in female (11/16, χ² = 4.867, P<0.05). Liver damage was found in all of 26 patients who were HBeAg positive on admission, 34 patients who were HBV DNA positive on admission, and 36 patients who developed sepsis in the process of treatment; the proportions were significantly higher than those in patients who were HBeAg negative on admission (20/28), patients who were HBV DNA negative on admission (12/20), and patients who did not develop sepsis in the process of treatment (10/18), with χ² values respectively 11.801, 18.384, and 20.574, P values below 0.01. (2) The incidence of HBV reactivation in these patients was 29.6% (16/54). Among all the patients, the proportion of HBV reactivation was 13/38 in male and 3/16 in female, with no statistically significant difference between them (χ² = 0.656, P>0.05). The proportions of HBV reactivation in patients who were HBeAg positive on admission, patients who were HBV DNA positive on admission, and patients who developed sepsis in the process of treatment were respectively 13/26, 16/34, and 15/36, and they were significantly higher than those in patients who were HBeAg negative on admission (3/28), patients who were HBV DNA negative on admission (0/20), and patients who did not develop sepsis in the process of treatment (1/18), with χ² values respectively 9.979, 18.615, and 5.873, P<0.05 or P<0.01.
  
  
  CONCLUSIONS
  Patients who are HBsAg positive, HBeAg positive, HBV DNA positive on admission, and develop sepsis in the process of treatment of extremely severe burn injury are more likely to develop liver damage and HBV reactivation. It is necessary to dynamically monitor the changes in HBV DNA and liver function, in order to identity the reactivation of virus.
authors.affiliation: Department of Burns and Wound Repair Surgery, Guangdong General Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, China.
authors.forename: Huining
authors.initials: H
authors.lastname: Bian
authors.affiliation: Department of Burns and Wound Repair Surgery, Guangdong General Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Lai
authors.affiliation: Department of Burns and Wound Repair Surgery, Guangdong General Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, China.
authors.forename: Shaoyi
authors.initials: S
authors.lastname: Zheng
authors.affiliation: Department of Burns and Wound Repair Surgery, Guangdong General Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, China.
authors.forename: Zu'an
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Burns and Wound Repair Surgery, Guangdong General Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, China.
authors.forename: Zhifeng
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Department of Burns and Wound Repair Surgery, Guangdong General Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, China.
authors.forename: Chuanwei
authors.initials: C
authors.lastname: Sun
authors.affiliation: Department of Burns and Wound Repair Surgery, Guangdong General Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, China.
authors.forename: Lianghua
authors.initials: L
authors.lastname: Ma
authors.affiliation: Department of Burns and Wound Repair Surgery, Guangdong General Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, China.
authors.forename: Hanhua
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Burns and Wound Repair Surgery, Guangdong General Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, China; Email: gdburns@163.com.
authors.forename: Huade
authors.initials: H
authors.lastname: Chen
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D002056:Burns / Q000150:complications* / Q000188:drug therapy*; D056486:Chemical and Drug Induced Liver Injury; D004279:DNA, Viral; D005260:Female; D006508:Hepatitis Antibodies / Q000097:blood; D006509:Hepatitis B / Q000188:drug therapy / Q000453:epidemiology / Q000821:virology; D006514:Hepatitis B Surface Antigens / Q000097:blood / Q000276:immunology; D006515:Hepatitis B virus / Q000187:drug effects* / Q000276:immunology / Q000302:isolation & purification; D019694:Hepatitis B, Chronic / Q000097:blood / Q000473:pathology / Q000821:virology; D006801:Humans; D015994:Incidence; D008099:Liver / Q000473:pathology; D008297:Male; D012189:Retrospective Studies
chemical_list: D004279:DNA, Viral; D006508:Hepatitis Antibodies; D006514:Hepatitis B Surface Antigens; D000410:Alanine Transaminase