| Objective: To investigate whether chronic hepatitis B with different level of serum HBeAg have different clinic characteristis and pathological stages. Methods: Both liver biopsy samples and sera were collected in patients with CHB in our unit during March 2007 to June 2010 consecutively. The pathological analysis of biopsy sample was distinguished 5 levels to inflammation (G) and fibrosis (S) stages separately, which in expression of G 0~4 and S 0~4. The mean value of HBeAg were calculated at different liver inflammation and fibrosis stages and analyzed by variance analysis(one-way ANOVA) .The relationships between HBeAg and liver pathological stages were analyzed by Spearman rank correlation analysis.Then the data was devided into four groups according to the serum HBeAg state and titre. The comparison of the mean value between measurement data groups is performed using variance analysis(one-way ANOVA), the comparison of the mean value of more than two ordered groups is performed using Kruskal-Wallis H rank sum test, and the comparison between either two groups using Nemenyi test. The data of patients who were diagnosed with CHB and treated with peginterferon alfa-2a were analyzed retrospectively. The comparison of rate of different groups is performed using chi-square test. Results: 430 patients who had liver biopsy were included.The mean value of HBeAg(s/co) at liver inflammation Stages G0~1 to G4 were ( X±95%CI) 888.881±335.965s/co, 882.215±126.004s/co , 463.371±77.923s/co ,197.284±73.218s/co, the mean value of HBeAg(s/co) at liver inflammation Stages S0~1 to G4 were ( X±95%CI) 967.749±134.550 s/co, 723.256±126.616 s/co,375.209±94.231 s/co,201.072±60.776 s/co. One-way ANOVA showed that the four groups of mean value above were significant different(F=25.505,P<0.001), the differences existed between Stage G0~1 and G4,G2 and G3,G2 and G4,G3 and G4. Similarly, the mean value of HBeAg at liver fibrosis Stages S0~1 to S4 were significant different(F=43.116,P<0.001), the differences existed between Stage S0~1 and S3,S0~1 and S4,S2 and S3,S2 and S4,S3 and S4. Spearman rank correlation analysis showed that there was correlation between HBeAg and liver inflammation and fibrosis stages, the correlation coefficients were -0.418,-0.513. Depending on the HBeAg titre, the patient were devided into four groups - the HBeAg negetive CHB,CHB with low serum HBeAg (1~100s/co),CHB with middle serum HBeAg(100~1000 s/co) and CHB with serum HBeAg titre higher than 1000s/co. The serum ALT(U/L) level of 4 groups were 185.574±48.411, 164.000±60.601,262.339±50.818,278.480±72.290.One-way ANOVA showed that the difference was significant between four groups(F=3.547,P=0.015).The serum Lg(HBVDNA) of four groups were 4.274±0.215,5.294±0.270,6.336±0.228, 7.114±0.264,the difference was significan(tF=107.506,P<0.001). Comparing to the high HBeAg level CHB, the inflammation and fibrosis stages were more severe in the low and middle HBeAg level. 60 patients were included to investigate the influence that may be induced by the different HBeAg state of CHB. After the treatment with peginterferon alfa-2a for 48 weeks, 61.9% (13/21)patient of the low HBeAg level group achieved HBeAg lost,while the high HBeAg level were 16.7%(5/30),the different was significant at the level of 0.05(P=0.014,2=6.020). Those patients whose HBeAg level reduced more than 80% in the six mouth of the theatment had a higher HBeAg lost rate(44.4%,16/36) than others (0.0%,0/11),the difference was significant either(P=0.009,2=7.412). Conclusions: The HBeAg level might relate to inflammation and fibrosis stages in liver of patients of HBeAg postive CHB.The CHB with lower serum HBeAg level has different clinic characteristis,pathological stages and response to peginterferon alfa-2a treatment. |
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