Hepatitis B e antigen–negative chronic hepatitis b in Hong Kong

✍ Scribed by Henry L. Y. Chan; Nancy W. Y. Leung; Munira Hussain; May L. Wong; Anna S. F. Lok

• Publisher: John Wiley and Sons
• Year: 2000
• Tongue: English
• Weight: 81 KB
• Volume: 31
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.510310330

✦ Synopsis

Hepatitis B e antigen-negative chronic hepatitis B (eϪCHB) has been reported in Asia but its prevalence and clinical significance have not been determined. The aims of this study were to determine the prevalence of eϪCHB in Hong Kong and the frequency of precore and core promoter mutations in these patients. A cross-sectional study was performed in 350 consecutive Chinese patients (230 men and 120 women; mean age ؎SD, 42 ؎ 13 years) with chronic hepatitis B virus infection. A total of 243 (69%) patients were hepatitis B e antigen (HBeAg)-negative of whom 15% had clinical cirrhosis. In the remaining 85% of patients, 63% had normal and 22% had elevated transaminases. Serum hepatitis B virus (HBV) DNA was detectable using branched DNA assay in 46% of HBeAg-negative patients with clinical cirrhosis/elevated transaminases. Forty-five percent of the patients with eϪCHB had the precore stop codon mutation, and an additional 41% had core promoter changes. There was no correlation between the presence of precore/core promoter mutations and liver disease or HBV-DNA levels. Overall, 17% of HBeAg-negative patients were viremic and had evidence of chronic liver disease (eϪCHB) with mean HBV-DNA levels comparable with that in HBeAg-positive patients. In summary, we found that eϪCHB may be present in up to 17% of HBeAg-negative patients seen in a tertiary referral center in Hong Kong. eϪCHB may be a heterogenous condition and is not invariably associated with the precore HBV mutant. Population studies are needed to determine the true prevalence of eϪCHB in Asia and to assess its natural course and response to treatment. (HEPATOLOGY 2000;31:763-768.