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Hepatitis B e antigen–negative chronic hepatitis b in Hong Kong
Author(s) -
Chan Henry L. Y.,
Leung Nancy W. Y.,
Hussain Munira,
Wong May L.,
Lok Anna S. F.
Publication year - 2000
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.510310330
Subject(s) - medicine , hbeag , hepatitis b virus , cirrhosis , hepatitis b , liver disease , virology , antigen , immunology , population , gastroenterology , virus , hbsag , environmental health
Hepatitis B e antigen–negative chronic hepatitis B (e−CHB) 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 e−CHB 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 e−CHB 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 (e−CHB) with mean HBV‐DNA levels comparable with that in HBeAg‐positive patients. In summary, we found that e−CHB may be present in up to 17% of HBeAg‐negative patients seen in a tertiary referral center in Hong Kong. e−CHB 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 e−CHB in Asia and to assess its natural course and response to treatment.