Objective To determine the differential clinical characteristics between hepatitis B e antigen (HBeAg) - positive and - negative patients with chronic hepatitis B virus (HBV) infection who are over 40 - years - old. Methods A total of 186 patients with chronic HBV and over 40 - years - old were analyzed, including 93 HBeAg - positive patients and 93 HBeAg - negative patients. Results In the HBeAg - positive group, 76.34% were male and 78.49% had a family history of HBV infection. The HBeAg - positive group had higher levels of HBV DNA and ALT, and a higher proportion of cirrhosis cases, than the HBeAg - negative group. Ascites were detected in patients from both groups diagnosed with decompensated cirrhosis. Upper gastrointestinal bleeding was more frequent in the HBeAg - negative group. Conclusion In our study of chronic HBV patients over 40 - years - old, HBeAg - positivity was more frequent in males with a family history of HBV. HBeAg - negativity was more frequently associated with liver cirrhosis. It is possible that progression of chronic HBV may be related to high levels of HBV DNA and persistent liver inflammation;%目的 探讨40岁以上HBeAg阳性和HBeAg阴性慢性HBV感染者的临床特点.方法 收集40岁以上慢性HBV感染者共186例,其中HBeAg阳性组93例,HBeAg阴性组93例.结果 40岁以上HBeAg阳性慢性HBV感染者男性为多(76.34％),并且多有乙型肝炎家族聚集现象( 78.49％)；40岁以上HBeAg阳性慢性HBV感染者的HBV DNA水平与ALT水平均高于HBeAg阴性慢性HBV感染者；40岁以上乙型肝炎肝硬化患者中,HBeAg阳性者占少数；40岁以上乙型肝炎肝硬化失代偿期患者中,HBeAg阳性者多合并腹水形成,而HBeAg阴性者既可见腹水形成,又可见上消化道出血.结论 40岁以上HBeAg阳性慢性HBV感染者多见于男性,多具有家族聚集现象,HBeAg阳性肝硬化患者所占比率较低,但HBV DNA水平较高,肝脏的炎症活动明显,病情进展可能较快.
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