| BACKGROUND AND AIMS Hepatitis B virus(HBV)is a well-known agent of acute and chronic hepatitis,it distributes all over the world.It is said by the World Health Organization(WHO),HBV has infected about 2 billion individuals worldwide and caused chronic liver diseases about 350 million,over 1 million has died of HBV-related liver failure,liver cirrhosis(LC-B)or hepatocelluar carcinoma(HCC)annually. China is a hyperepidemic area of HBV infection.The prevelance of HBsAg carriers is as high as 9.09%among the general population in China,and the number of chronic heptitis B patients is more than 20 million.The probability is around 25%to advanced to be LC or HCC who was infected below 6 years old.Therefore,viral hepatitis B is a major public health problem in China and has a substantial impact on the health of people.Those with chronic HBV may present in 1 of 4 phases of infection:(1) in a state of immune tolerance,(2)with hepatitis B e antigen (HBeAg)positive chronic hepatitis,(3)as an inactive hepatitis B surface antigen carrier,or(4)with HBeAg-negative chronic hepatitis.Recently, more and more studies about HBeAg-negative chronic hepatitis B(CHB) appeared,but there are many differences in the results.At present,eight genotypes of HBV have been determined based on a divergence over the entire genomic sequence=8%or over the S gene sequence=4%,and they are named with capital letters from A to H.There is important significance in reserching the HBV genotypes in HBeAg negative chronic HBV infection to understand its characteristics of the epidemiology,pathogenesis,prognosis, diagnosis and treatment.To investigate the proportional change,the Antiviral Therapy and the HBV genotype of HBeAg negative CHB and LC-B in this area during the past 10 years,the study was conducted.METHODS 2561 hospitalized CHB and LC-B cases from 1996,2001 and 2006 were analyzed retrospectively.HBV genotypes were determined in 220 patients with CHB or LC-B by using nested polymerase chain reaction based on genotype specific primers.The statistics were made by SPSS for windows.Diference were considered statistically significant at a P vlaue of＜0.05(two sides).RESULTS Among the 2561 cases,2024 were males,the median age is 38 years old(1～79).The proportion of HBeAg-negative LC-B(50.0%)was higher than CHB(23.8%),P＜0.01.It was rising from 46.1%in 1996 to 54.4%in 2006 during the past 10 years,P=0.014.The rate of antiviral therapy was also rising during the past 10 years in both HBeAg negative and HBeAg positive cases,no matter in CHB or LC-B,P＜0.01.It was higher in CHB than in LC-B(61.9%VS 46.0%,P＜0.01).In the HBeAg negative patients,the antiviral therapy rate of CHB(50.0%)was higher than that of LC-B(38.8%),P=0.002;both of which were lower than that in HBeAg positive patients(65.7%in CHB and 53.2%in LC-B),P＜0.01.166(89.73%) were identified for HBV genotypes among the 185 CHB cases,while 27(77.14%)in LC-B cases.There were genotype C,B and B/C in the 193 cases which can be identified for HBV genotypes.Genotype A,D,E and F were not found.The percentage of genotype C and B/C mixed genotype in HBeAg negative CHB and LC-B are 94.7%,5.3%and 90.0%,10.0% respectively in this area,which are not statistically different from the HBeAg positive patients.No genotype B and other genotypes were found.CONCLUSIONS In this area,HBeAg-positive is still the predominant form of hospitalized CHB,the propotion of HBeAg-negative LC-B is more than 50%recently and is higher than 5～10 years ago. Genotype C predominates the genotypes in both HBeAg negative and HBeAg positive patients.No genotype B was found in HBeAg negative patients.The rate of antiviral therapy was rising during the past 10 years,it is still lower in HBeAg negative patients than in HBeAg positive patients. The antiviral therapy of HBeAg negative CHB and LC-B should be thought more,especially of LC-B. |
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