Clinical Characteristics and Treatment for Patients with Occult Chronic hepatitis B

摘要

Objective To observe the clinical manifestations and assess direct antiviral effect for patients with occult hepatitis B in China. Methods The study includes 15 patients with occult hepatitis B and their medical history, family history, ifrst-diagnosis time, conifrmed-diagnosis time, laboratory report, anti-viral therapy and outcomes were analyzed. Results The average age of the patients is 38.67-year old (6 males and 9 females), 2 with acute hepatitis B (2/15, 13.3%), 13 with no hepatitis history (13/15, 86.6%), 8 with family history (8/15, 53.3%), 6 with no family history (6/15, 40%), 1 with unknown family history (1/15, 6.6%). Eight patients were treated with entecavir (0.5 mg/day, taken orally), with effective results and steady conditions;3 patients were treated with lamivudine (0.1 g/day, taken orally), 2 of them were prescribed to take adefovir dipivoxil additionally due to drug-resistance, the other one was treated with lamivudine continuously without drug-resistance;4 cases refused anti-viral therapy. One patient’s condition remained steady, 1 patient died of cirrhosis with portal hypertension and liver failure 5 years after ifrst-diagnosis, 1 patient progressed to hepatocellular carcinoma and accepted surgery operation treatment 5 years after ifrst-diagnosis, the other 1 patient progressed to compensatory cirrhosis 2 years after ifrst-diagnosis and is steady from then, which indicates that occult chronic hepatitis B can progress to cirrhosis and hepatocellular carcinoma without therapy in time. Conclusions The clinical characteristics of 15 cases with occult chronic hepatitis B showed that these patients with short latency, younger age when being-struck, and light damage to liver function. The efifcacy and drug-resistance of nucleos(t)ide-analogue (entecavir, lamivudine, adefovir dipivoxil) in treatment of patients with occult chronic hepatitis B are similar to chronic hepatitis B.