Persistence of acute infection with hepatitis B virus genotype A and treatment in Japan
Persistence of acute infection with hepatitis B virus genotype A and treatment in Japan
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DOI：
10.1002/jmv.20320
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发表时间：
2005-05-01
影响因子：
12.7
通讯作者：
Kumada, H
中科院分区：
文献类型：
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作者：
Suzuki, Y;Kobayashi, M;Kumada, H
在1976年至2003年的28年间，东京都虎之门医院收治的97例成人急性B型肝炎患者中，31例（32%）感染了B型肝炎病毒（HBV）A型，9例（9%）感染了B型，44例（45%）感染了C型，E型和F型各1例（1%）。其余11例（11%）患者的HBV无法分型。所有31例由HBV A型感染引起的急性B型肝炎患者均为男性，中位年龄为31岁，16例（52%）通过婚外性接触感染。7例（23%）HBV A型感染持续存在的患者的基线HBV DNA水平高于其余24例（77%）自发消退的患者（中位数：> 8.7 vs 6.0 log基因组当量/ml，P = 0.004）。丙氨酸氨基转移酶最大值< 500 IU/L的患者比丙氨酸氨基转移酶最大值≥ 500 IU/ L的患者更易发生持续性感染（83% [5/6] vs. 4% [1/25]，P = 0.0001）。6例持续HBV A基因型感染的患者接受干扰素和/或拉米夫定治疗慢性活动性肝炎，3例（50%）应答为B e抗原（HBeAg）丢失; 1例依次接受干扰素和拉米夫定治疗的患者血清中的B表面抗原（HBsAg）清除。在其余三名接受抗病毒治疗的患者以及另一名未接受治疗的患者中，HBV基因型A与HBeAg沿着持续存在。总之，在日本急性B型肝炎患者中，HBV基因型A感染占优势，基因型B和C常见，通常通过性接触感染（16/31 [52%]），并倾向于持续感染（7/31 [23%]）。在接受抗病毒治疗的6名患者中，只有1名（17%）感染被清除。(c)2005 Wiley-Liss，Inc.
Among the 97 adult patients with acute hepatitis B who were admitted to the Toranomon Hospital in Metropolitan Tokyo during 28 years from 1976 to 2003, 31 (32%) were infected with hepatitis B virus (HBV) genotype A, nine (9%) with genotype B, 44 (45%) with genotype C, one (1%) each with genotypes E and F. HBV in the remaining 11 (11%) patients were untypeable. All the 31 patients with acute hepatitis B caused by HBV genotype A infection were male with a median age of 31 years, and 16 (52%) contracted infection through extramarital sexual contacts. The baseline HBV DNA level was higher in the seven (23%) patients in whom infection with HBV genotype A persisted than the remaining 24 (77%) with spontaneous resolution (median: > 8.7 vs. 6.0 log genome equivalents/ml, P = 0.004). Persistent infection was more frequent in patients with maximum alanine aminotransferase < 500 IU/Lthan >= 500 IU/ L (83% [5/6] vs. 4% [1/25], P = 0.0001). Of the six patients with persistent HBV genotype A infection who received interferon and/or lamivuidine for treatment of chronic active hepatitis, three (50%) responded with the loss of hepatitis B e antigen (HBeAg); hepatitis B surface antigen (HBsAg) was cleared from serum in one patient who received interferon and lamivudine in sequence. HBV genotype A persisted along with HBeAg in the remaining three patients given antiviral therapy as well as another who was not treated. In conclusion, infection with HBV genotype A prevails in patients with acute hepatitis B in Japan where genotypes B and C are common, is often contracted sexually (16/31 [52%]) and tends to persist (7/31 [23%]). Infection was cleared in only one of the six (17%) patients who received antiviral therapy. (c) 2005 Wiley-Liss, Inc.