BackgroundIn this study, we aim to determine the hepatic pathological changes in HBV DNA-negative chronic Hepatitis B (CHB) patients after 12-month antiviral therapy.MethodsBlood routine indicators including platelet count (PLT) and white blood cell (WBC) were determined. The coagulation function was evaluated by determining the prothrombin time (PT) and prothrombin time activity (PTA), together with the HBV DNA quantification and alpha fetoprotein (AFP). The virology data included hepatitis B surface antigen (HBsAg)/antibodies against hepatitis B surface antigen (anti-HBs), hepatitis B e antigen (HBeAg)/antibodies against hepatitis B e antigen (anti-HBe) and antibodies against hepatitis B core antigen (anti-HBc) were tested. Pathological assay was performed to the liver puncture tissues. Based on the HBV DNA data in the 12-month follow-up of the cases that received anti-viral therapy during this time, the experimental group was divided into group A (HBV DNA negative at the baseline level, HBV DNA negative after 12 months, N = 79) and group B (HBV DNA negative at the baseline level, HBV DNA turning to be positive after 12 months, N = 13). Statistical analysis was performed on the each test index of the two groups.ResultsThe inflammation grade of group A showed significant improvement after 12-month treatment (P < 0.05). The pathological inflammation grade of group B was increased after one year, and the liver function indices and the PTA (P < 0.05) levels were all increased. Pathological results indicated that the proportion of disease progression in group A was decreased after 12-month follow-up while that proportion was increased in group B. Significant differences were noticed in AFP levels between the patients with progression in group A and those with progression in group B.ConclusionNegative HBV DNA does not mean a controlled hepatitis B. Hepatitis B patients transferred to HBV DNA positivity during the anti-viral therapy are easily to show disease progression, and then special attention should be paid to the HBV DNA monitoring. Meanwhile, close monitoring to the changes of liver function, PTA and AFP levels may help to detect changes on the disease in a timely manner.

中文翻译：

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HBV DNA阴性慢性乙型肝炎患者一年后肝脏病理变化

背景本研究旨在了解HBV DNA阴性慢性乙型肝炎（CHB）患者抗病毒治疗12个月后的肝脏病理变化。方法测定血小板计数（PLT）和白细胞（WBC）等血常规指标。通过测定凝血酶原时间 (PT) 和凝血酶原时间活性 (PTA) 以及 HBV DNA 定量和甲胎蛋白 (AFP) 来评估凝血功能。病毒学数据包括乙肝表面抗原（HBsAg）/乙肝表面抗原抗体（anti-HBs）、乙肝e抗原（HBeAg）/乙肝e抗原抗体（anti-HBe）和乙肝核心抗原抗体(抗-HBc) 进行了测试。对肝穿刺组织进行病理学检测。根据在此期间接受抗病毒治疗的病例随访12个月的HBV DNA数据，将实验组分为A组（基线水平HBV DNA阴性，12个月后HBV DNA阴性） ，N = 79）和 B 组（基线水平 HBV DNA 阴性，12 个月后 HBV DNA 转为阳性，N = 13）。对两组各项检测指标进行统计分析。结果A组治疗12个月后炎症分级有明显改善（P<0.05）。1年后B组病理炎症分级升高，肝功能指标和PTA（P < 0.05）水平均升高。病理结果显示，A组疾病进展比例在随访12个月后降低，而B组患者比例升高。 B组结论HBV DNA阴性并不意味着乙肝得到控制。乙肝患者在抗病毒治疗过程中转为HBV DNA阳性很容易出现疾病进展，应特别注意HBV DNA的监测。同时，密切监测肝功能、PTA、AFP水平的变化，有助于及时发现疾病的变化。A组进展患者与B组进展患者的AFP水平存在显着差异。结论HBV DNA阴性并不意味着乙型肝炎得到控制。乙型肝炎患者在抗病毒治疗期间很容易转为HBV DNA阳性。以显示疾病进展，然后应特别注意HBV DNA监测。同时，密切监测肝功能、PTA、AFP水平的变化，有助于及时发现疾病的变化。A组进展患者与B组进展患者的AFP水平存在显着差异。结论HBV DNA阴性并不意味着乙型肝炎得到控制。乙型肝炎患者在抗病毒治疗期间很容易转为HBV DNA阳性。以显示疾病进展，然后应特别注意HBV DNA监测。同时，密切监测肝功能、PTA、AFP水平的变化，有助于及时发现疾病的变化。