Acute HBV infection study for e-antigen negative vs positive patients

[PinoyHBVDNA]

http://www.annalsofhepatology.com/PDF/vol5n2/Hp062-05.pdf

Background: Despite the availability of effective vaccines,hepatitis B virus (HBV) infection is still frequent worldwide,and accounts for significant morbidity and mortality.However, data of acute HBeAg negative hepatitis stillremain limited. Aims and Methods: To understand clinicalpictures of acute HBV hepatitis and its natural volution,a prospective study was conducted in adult patients.Results: Ninety patients were enrolled between March 2004 and April 2005 at Hospital for Tropical Diseases in Ho Chi Minh city. The prevalence of HBeAg negative was 53%. No significant difference was found in clinical characteristics and laboratory findings between HBeAg positive and negative patients. HBV-DNA was detected in 75% and 88% HBe negative and positive patients, respectively, where the frequency of ALT below 400 U/L was significantly higher in HBeAg negative cases (p = 0.01). Six month follow-up was available in 47 patients. HBsAg positivity was found in 16% of HBeAg negative subjects but only in 4.5% of HBeAg positive cases. Thirty two patients had neither HBsAg nor anti-HBs. Conclusions: The clinical and laboratory feature and the outcome at 6 months of HBV acute hepatitis in Vietnam is similar in HBeAg positive and negative patients.

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But if you read the actual document the chances of death/ fulminant hepatitis and chronic infection was higher in those with Acute HBEAG-negative infection, but the number of patients was relatively small only 48 (hbeag-) vs 42 (hbeag+) and the end values are statistically insignificant

Just sharing.

[PinoyHBVDNA]

here's another

http://onlinelibrary.wiley.com/doi/10.1002/jmv.1890020206/abstract?systemMessage=Wiley+Online+Library+will+be+disrupted+4+Feb+from+10-12+GMT+for+monthly+maintenance
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The influence of e-antigen upon the course and outcome of acute type B hepatitis was studied in a series of 202 patients. Of these, 54 (27%) had e-Ag, detected in the serum at the same time as HBsAg during the incubation period or at onset. In 39 patients (73%) the e-Ag disappeared within eight weeks after onset, regularly followed by clearance of HBsAg approximately four weeks later; anti-HBs was detected shortly thereafter in 34 cases. In 15 (28%) of e-Ag-positive and in 4 (3%) of e-Ag-negative patients, HBsAg persisted for one year or longer; chronic hepatitis developed in 13 of these cases, 12 of which were e-Ag-positive. Among e-Ag-positives HBsAg persisted only in those cases in which the e-Ag also persisted; all these were persons under 15 years of age. Transaminase and bilirubin values were equally high in e-Ag-positive and e-Ag-negative patients with resolving hepatitis, but were low from the start in those who later developed chronic liver conditions, irrespective of the presence or absence of e-Ag. It is concluded that in e-Ag-positive acute type B hepatitis patients the disappearance of this antigen from the serum is a good prognostic sign, whereas its persistence beyond eight weeks, especially in young children with low transaminase and bilirubin response, signals evolution towards chronicity.

SUMMARY

148 HBEag negative
54 HBEag positive

cleared hbsag after 8 weeks
39/ 54

developed Anti-HBS after 12 weeks
34/ 54

became chronic
12/54 HBEag positive
1/148 HBEag negative

[PinoyHBVDNA]

but according to this study done in 1972 (though old) , the observation seems to be the other way around

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1639162/pdf/brmedj00509-0018.pdf

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Summary
To examine the association between e antigen and
hepatitis-B surface antigen (HBs Ag) we studied 90 inpatients
with acute viral hepatitis type B. e Antigen was
present in 24 of the patients; these patients had detectable
levels of HBs Ag for significantly longer than the 66 with
no e antigen in their serum. The HBs Ag subtypes D
(adw) and Y (ayw) were similarly distributed among
patients with e antigen and among those without, and
no differences in the results of biochemical liver function
tests were observed between the two groups during the
acute phase of illness. Three of the five patients who
developed clinical and histological signs of chronic liver
disease were positive for e antigen, a finding which supports
the hypothesis that e antigen has a prognostic value
in hepatitis B.

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In 83 patients regular analyses for HBs Ag were performed every
two to three weeks until the antigen was no longer demonstrable or
for at least 15 weeks. Four weeks after onset of illness HBs Ag was
still demonstrable in the serum in 62% of patients positive for e
antigen but only 23% of those negative for e antigen (P <0 05) (see
fig).

HBs Ag persisted for more than 6 months in the serum of three
e-positive (13%) and two e-negative patients (3%) The remaining 78
patients all became HBs Ag-negative and had normal liver function
within four months of the onset of illness.