| 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 were recruited into the study and divided into two groups according to the HBeAg status. 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:Of the 353 in-patients, 236(66.8%) patients were HBeAg-negative. 117(33.2%) patients were HBeAg- positive. The ratio of HBeAg-positive patients was significantly higher than that of HBeAg-positive patients (p<0.05).The average age of HBeAg-negative patients was older than that of HBeAg-positive patients (P=0.048). The serum HBV DNA level of HBeAg-negative patients was significantly lower than that of HBeAg-positive patients (5.49±2.02) vs(6.64±1.41) log copies/ml (p<0.01).The ratio of patients who had a serum HBV DNA level less than 5log copies/ml in HBeAg-negative patients was significantly higher than that in HBeAg-positive patients (41.8% vs 11.9% ,p=0.000). 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.Conclusions : The study suggested that serological chemistry data, morbility of complications and prognosis of the disease of HBeAg-negative patients mimics that 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) . Objective: To investigate the therapeutic efficacy of foscarnet sodium in the treatment of patients with severe chronic hepatitis B.Methods: Forty four patients were randomly divided into foscarnet sodium treatment and placebo groups.Each group consisted of 22 patients, 22 patients in foscarnet sodium group were treated with foscarnet sodium twice daily 3.0g given by intravenous infusions ,in addition to general therapy for 28 days.The other 22 cases were treated without any form of antiviral therapy as control.All patients were followed up for 6 months.The HBV markers, quantification of HBV-DNA, serological chemistry data were measured at baseline , during therapy period and the end of follow-up period .Results: Clinical symptoms were improved in Two groups patients, meanwhile alanine aminotransferase (ALT) and total serum bilirubin (TBiL) decreased. At the end of foscarnet sodium treatment, the alanine aminotransferase (ALT) decreased from (624.18±729.330) u/L to ( 48.27±34.46) u/L, the total serum bilirubin (TBiL) decreased from (253.95±100.98)μmol/L to (89.96±114.52)μmol/L.In the placebo group, ALT decreased from (374.32±345.18)u/L to (45.35±21.13)u/L.TbiL decrease from (195.58±85.360)μmol/L to (57.53±62.76)μmol/L.Compare ALT and TBiL at the end of trentment, there were no significant differences between the two groups (p>0.05). In foscarnet sodium treatment group, the level of serum HBV-DNA descreased from (6.993±0.898) log copies/ml to( 4.033±1.286) log copies/ml (p<0.05), the rate of HBV-DNA descrease of more than two log was 81.1%(18/22). In the control group, the level of serum HBV-DNA descreased from( 7.068±0.938) log copies/ml to (5.188±1.926 )log copies/ml, the rate of HBV-DNA descrease of more than two log was 45.4%(10/22).A comparison of serum HBV-DNA showed significant differences between the two groups(p<0.05) The efficiency was 42.9% and 30.0% respectively in foscarnet sodium treatment groups and placebo group at the end of follow up period .Conclusion : foscarnet sodium administered can inhibit HBV replication in treating severe chronic hepatitis B.It can rapid lower the level of serum HBV-DNA obviously.But the relapse rate was 47.0% in foscarnet sodium treated at the end of follow up period... |
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