Effect of seasonal variation on the clinical course of chronic hepatitis B
Effect of seasonal variation on the clinical course of chronic hepatitis B
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DOI：
10.1007/s00535-006-1903-1
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发表时间：
2006-11-01
影响因子：
6.3
通讯作者：
Gu, Yan-Li
中科院分区：
文献类型：
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作者：
Zhang, Shi-Jun;Chen, Ze-Xiong;Gu, Yan-Li
免疫力的季节性变化已在健康个体中发现，并与某些疾病有关。季节性变化是否影响慢性B型肝炎的临床病程尚不清楚。为探讨季节性变化对慢性B型肝炎临床病程的影响，观察了慢性B型肝炎（CHB）患者中B型肝炎病毒（HBV）感染者的发病时间和缓解时间。所有入组患者至少每3个月随访一次，平均随访时间为24.0（范围，12-60）个月。采用季节分解法分析2238例慢性B肝炎患者随访期间乙型肝炎B e抗原（HBeAg）血清学转换、复发和缓解与季节变化的关系。在随访期间（平均36个月），1076例（48.08%）丙氨酸氨基转移酶（ALT）水平低于2.0 ×正常上限（ULN）的患者很少出现爆发和HBeAg血清转换。其余1162例ALT水平N2.0 × ULN的患者（51.92%）（766例HBeAg阳性; 387例抗-HBeAg阳性; 9例HBeAg和抗-HBeAg均阴性）纵向随访12个月，以判断发作、缓解和HBeAg血清转换。ALT水平N2.0 × ULN的患者中，爆发、缓解和HBeAg血清转换表现出明显的季节性模式（P < 0.001），分别在春季、夏季和夏季达到高峰。自相关分析表明，慢性B型肝炎的发作、缓解和HBeAg血清转换在冬、春、夏、秋四季具有明显的周期性，季节性变化可能影响慢性乙型肝炎的临床病程。应进一步调查季节性触发因素的作用。
Seasonal variation in immunity has been found in healthy individuals and in association with some diseases. It is still unknown whether seasonal variation affects the clinical course of chronic hepatitis B. Our aim in this study was to explore the effect of seasonal variation on the clinical course of chronic hepatitis B.The flare and remission time of chronic hepatitis B were observed in patients with hepatitis B virus (HBV) infection. All patients enrolled were followed up at least every 3 months for a mean follow-up time of 24.0 (range, 12-60) months. Seasonal decomposition was employed to analyze the relationship between seasonal variation and flares, remission, and hepatitis B e antigen (HBeAg) seroconversion in chronic hepatitis B patients during follow-up.A total of 2238 patients were observed in our study. Flare and HBeAg seroconversion were seldom seen in 1076 patients (48.08%) with alanine aminotransferase (ALT) levels of less than 2.0 x upper limit of normal (ULN) during follow-up (mean, 36 months). The remaining 1162 patients (51.92%) (766, HBeAg positive; 387 anti-HBeAg positive; 9 negative for both HBeAg and anti-HBeAg) with ALT levels N2.0 x ULN were followed longitudinally for 12 months to judge flare, remission, and HBeAg seroconversion. Flare, remission, and HBeAg seroconversion in patients with ALT levels N2.0 x ULN showed clear seasonal patterns (P < 0.001), with high peaks during spring, summer, and summer, respectively. An autocorrelation correlogram showed that flares, remission, and HBeAg seroconversion occurred with distinct periodicity in winter, spring, summer, and autumn.Seasonal variation might affect the clinical course of chronic hepatitis B. The role of seasonal triggering factors should be further investigated.