Case-control study for the identification of virological factors associated with fulminant hepatitis B
Case-control study for the identification of virological factors associated with fulminant hepatitis B
复制标题
DOI：
10.1111/j.1872-034x.2009.00519.x
复制
发表时间：
2009-07-01
影响因子：
4.2
通讯作者：
Mizokami, Masashi
中科院分区：
文献类型：
--
作者：
Kusakabe, Atsunori;Tanaka, Yasuhito;Mizokami, Masashi
背景：宿主和病毒因素可以促进暴发性B型肝炎（FHB）的发展，但还没有病例对照研究，以找出病毒学参数，可以区分FHB。方法：在病例对照研究中，病毒学因素与FHB的发展，在50例FH由短暂的B病毒（HBV）感染（FH-T）和50例急性自限性B（AHB）谁是匹配的性别和年龄。结果：12例无症状HBV携带者（ASC）急性加重（AE）所致FH（FH-C）与12例非FH慢性B型肝炎（AE-C）AE所致FH（FH-C）患者中，HBVDNA高水平、B1/Bj、A1762 T/G1764 A、G1896 A、G1899 A和A2339 G变异发生率显著高于AHB（P < 0.05），而B e抗原在FH-T患者中的发生率低于AHB。在多变量分析中，G1896 A突变（比值比[OR]，13.53; 95%置信区间[CI]，2.75-66.64），血清HBV DNA大于5.23 log拷贝/mL（OR，5.14; 95%CI，1.10-24.15）和总胆红素超过10.35 mg/mL（OR，7.81; 95%CI，1.77-34.51）与一过性HBV感染的暴发性结局独立相关。另一方面，在FH-C和AE-C组之间的患者相比，有没有显着差异的病毒学因素与FHB的发展。结论：一些病毒学因素已被定义，可以区分FH-T AHB的病例对照研究。短暂性HBV感染与ASC的AE之间FHB的致病机制可能不同。
Background:Host and viral factors can promote the development of fulminant hepatitis B (FHB), but there have been no case-control studies for figuring out virological parameters that can distinguish FHB.Methods:In a case-control study, virological factors associated with the development of FHB were sought in 50 patients with FH developed by transient hepatitis B virus (HBV) infection (FH-T) and 50 with acute self-limited hepatitis B (AHB) who were matched for sex and age. In addition, 12 patients with FH developed by acute exacerbation (AE) of asymptomatic HBV carrier (ASC) (FH-C) were also compared with 12 patients without FH by AE of chronic hepatitis B (AE-C).Results:Higher HBV DNA levels, subgenotype B1/Bj, A1762T/G1764A, G1896A, G1899A and A2339G mutation were significantly more frequent (P < 0.05), while hepatitis B e-antigen was less frequent in the FH-T patients than AHB. In multivariate analysis, G1896A mutation (odds ratio [OR], 13.53; 95% confidence interval [CI], 2.75-66.64), serum HBV DNA more than 5.23 log copies/mL (OR, 5.14; 95% CI, 1.10-24.15) and total bilirubin more than 10.35 mg/mL (OR, 7.81; 95% CI, 1.77-34.51) were independently associated with a fulminant outcome by transient HBV infection. On the other hand, in comparison with the patients between FH-C and AE-C groups, there was no significant difference of virological factors associated with the development of FHB.Conclusion:A number of virological factors have been defined that may distinguish FH-T from AHB in a case-control study. The pathogenic mechanism of FHB between transient HBV infection and AE of ASC would be different.