HOW OFTEN DOES CHRONIC LIVER-DISEASE FOLLOW ACUTE HEPATITIS-B IN ADULTS
HOW OFTEN DOES CHRONIC LIVER-DISEASE FOLLOW ACUTE HEPATITIS-B IN ADULTS
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DOI：
10.1007/bf01642806
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发表时间：
1985-01-01
期刊：
影响因子：
7.5
通讯作者：
PAPAEVANGELOU, G
中科院分区：
文献类型：
--
作者：
ROUMELIOTOUKARAYANNIS, A;TASSOPOULOS, N;PAPAEVANGELOU, G
在一项针对患有急性黄疸型（临床明显）病毒性肝炎的成年人的前瞻性研究中，对原发性急性乙型肝炎病毒感染后发展为慢性乙型肝炎表面抗原（HBsAg）携带状态的风险进行了检测。在189例HBsAg阳性且甲型肝炎病毒IgM抗体阴性的患者中，乙型肝炎核心抗原IgM抗体（IgM抗 - HBc）的酶免疫测定结果为：176例（93.1%）阳性，13例（6.9%）阴性。前者被认为是急性乙型肝炎感染，后者被认为是慢性携带者再次感染另一种病毒或慢性感染的急性加重。6个月时，所有存活的急性乙型肝炎患者的HBsAg均已清除。所有存活的慢性携带者HBsAg仍为阳性。在另一项前瞻性研究中，18名患有亚临床乙型肝炎感染的成年人也在6个月内清除了HBsAg。这些数据表明，与新生儿和儿童相反，成年患者在急性乙型肝炎感染后很少发展为慢性抗原血症。假定的风险应主要归因于对慢性携带者再次感染或慢性感染急性加重病例的误诊。
The risk of developing the chronic hepatitis B surface antigen (HBsAg) carrier state after primary acute hepatitis B virus infection was examined in a prospective study of adults with acute icteric (clinically apparent) viral hepatitis. Enzyme immunoassay for IgM antibody to hepatitis B core antigen (IgM anti-HBc) was positive in 176 (93.1%) and negative in 13 (6.9%) of 189 patients positive for HBsAg and negative for IgM antibody to hepatitis A virus. The former were considered to be acute hepatitis B infections and the latter chronic carriers superinfected with another virus or acute exacerbation of chronic infection. At six months, all surviving acute hepatitis B patients had cleared HBsAg. All surviving chronic carriers remained HBsAg-positive. In another prospective study, 18 adults with subclinical hepatitis B infection also cleared HBsAg within six months. These data suggest that in contrast to newborns and children, adult patients rarely develop chronic antigenemia after acute hepatitis B infection. The postulated risk should mainly be attributed to misdiagnosis of cases of superinfection of chronic carriers or acute exacerbation of chronic infection.