The Clinical Outcome Of1Year Period In The HBeAg Positive Chronic Infected Patients Who Above40Yreas Old

Objective: Study1-year clinical prognosis of HBeAg-positive chronic HBVinfected person over the age of40, providing the basis for clinical treatment andprognosis, and providing preliminary clinical data for further research.Methods: Collect103HBeAg-positive chronic HBV infection cases over the age of40from October2010to October2011in Yan’an University Hospital infection outpatientand inpatient, and collect103HBeAg-negative chronic HBV infection cases over the ageof40in the same period. All patients have no other hepatitis virus infections, and excludealcoholic liver disease, metabolic liver diseases and drug-induced hepatitis. Thediagnostic criteria is in line with the2010version of " prevention and treatmentguidelines for chronic hepatitis B,2009edition of " Chinese liver cancer treatmentguidelines." Perform the physical examination for the group patients and recheck, HBVM and HBV DNA, AFP, liver fibrosis, liver, type-B ultrasonic every3-6months,perform abdominal MRI or CT, endoscopy, and pathology for some patients, operatingstrictly according to instructions. All data are statistically analyzed by statistical softwareSPSS16.0, the χ~2test, measurement data taking±SD, M (QR)(median and interquartile range) are used according to the data, respectively taking t-test, Mann-WhitneyU test, α <0.05as the test standards.Results: 1. Under different HBeAg status, HBeAg-positive and negative groups more than40years age with chronic HBV infection situation have not significant difference (χ~2=3.210, P=0.073)in gender distribution.2. Under different HBeAg status, HBeAg-positive and negative groups more than40years age with chronic HBV infection have no significant difference (χ~2=1.924, P=0.165) in family gathering.3. HBeAg-positive and negative groups have no significant difference (χ~2=2.726,P=0.099)(χ~2=0.148, P=0.701) for cases more than40years of age with chronichepatitis B and liver cirrhosis and HCC incidence in different HBeAg status.4. Under different HBeAg status, the complication occurrence for cases with chronicHBV infection of more than40years: HBeAg-positive group:13cases with ascitesformation. HBeAg-negative group:13cases with ascites formation,4cases with uppergastrointestinal bleeding,1case with upper gastrointestinal bleeding and ascitesformation.5.The ALT, ALB, TB, and HA changes of more than40years with chronic HBVinfection through anti-viral treatment in1year.5.1In chronic hepatitis B group: HBeAg-positive group: The ALB level increasesafter one year. The difference is statistically significant (t=-3.391, P=0.001). The ALTreduce, the difference is statistically significant (Z=-2226, P=0.026). TB, HA has nosignificant changes. HBeAg-negative group: HA level increases after one year, withstatistically significant difference (Z=-3.019, P=0.00). ALB, ALT, TB level hassignificant change.5.2For cirrhotic patients: In the HBeAg positive group, HA level reducing after oneyear, the difference is statistically significant (Z=-2.817, P=0.005), no significantchange. While the negative group do not change significantly.6. ALB, ALT, TB, HA for patients more than40years with hepatitis B immune tolerantphase and immune control but no antiviral have no significant change in1year. 7. The clinical prognosis of HBeAg-positive and-negative chronic HBV infectionpatients over the age of40in one year: Two groups of patients have no statisticalsignificant difference in alleviation, stability and aggravation (χ~2=3.003, p=0.223)..8. Causes of death (incentives) for different HBeAg chronic HBV infection over40years: HBeAg-positive group, three cases dead of chronic liver failure; the negativegroup, four cases dead,1case dead of chronic liver failure,3of upper gastrointestinalbleeding.9the relationship of HBeAg level of HBeAg-positive chronic HBV infection andone year E seroconversion over the age of40,(ie, serum HBeAg to negative, appearingHBeAb): HBeAg level <100PEI U/ml,>100PEI U/ml, E system seroconversion are11cases (20.8%),2cases (5.4%). The difference is statistically significant (χ~2=4.154,P=0.042).Conclusion:1. HBeAg-positive chronic HBV infection and chronic HBV infection over theage of40is common in men, and often with family history (that is more than one casesof chronic HBV infection in first degree relatives). For the patient over40years withchronic HBV infection shall be further traced back the family history for early detectionand early diagnosis and treatment.2. The cirrhosis and HCC proportion of HBeAg-positive chronic HBV infection andHBeAg-negative chronic HBV infected persons over the age of40have no significantdifference. However, the upper gastrointestinal bleeding of HBeAg-positivedecompensated cirrhosis patients over the age of40is not common, uppergastrointestinal bleeding of HBeAg-negative patients is common.3. For HBeAg-positive chronic hepatitis B patients over the age of40, the liversynthesis of functional recovery faster after controlling the inflammatory activity of theliver by the reasonable antiviral treatment. There is no significant change in hepaticsynthetic function in cirrhosis patients, but liver fibrosis rate slows significantly. Therefore, HBeAg-positive chronic hepatitis B patients over the age of40shall seize theopportunity of antiviral therapy actively treat.4. Under different HBeAg status, chronic HBV infection patients over the age of40have no significant clinical prognosis difference in1year.5. In the chronic HBV patients over the age of40during1-year follow-up, mostHBeAg-negative hepatitis B patients with cirrhosis die of upper gastrointestinal bleedingcaused by improper diet, while hepatitis B HBeAg-positive patients with cirrhosis haveno supreme gastrointestinal bleeding cases.6. For chronic HBV patients over the age of40, the level of HBeAg can be aspredictors of nucleos (t) kind antiviral treatment, patients with lower HBeAg often havebetter antiviral treatment.