HBeAg negativity tied to advanced liver fibrosis in CHB patients

Serum hepatitis B e antigen (HBeAg)-negative patients with chronic hepatitis B (CHB) have more advanced liver fibrosis than HBeAg-positive CHB patients, according to a study.

“Serum HBeAg status is associated with the progression of CHB,” according to the investigators, who sought to examine the relationship between HBeAg status and liver pathology in CHB patients.

This study retrospectively enrolled a total of 683 treatment-naïve CHB patients who had undergone liver biopsy from two medical centres. The investigators carried out a propensity score-matching (PSM) method to adjust the imbalance of baseline confounders between HBeAg-positive and HBeAg-negative CHB patients.

Prior to PSM, HBeAg negativity correlated with more advanced liver fibrosis compared with HBeAg positivity (p<0.001). However, no significant difference was found in the distribution of inflammation grades between HBeAg-positive and HBeAg-negative CHB patients (p=0.051).

Of the 683 CHB patients, 123 were included in each group after PSM. Those with negative HBeAg still showed significantly advanced liver fibrosis as compared with those with positive HBeAg (p=0.03) after PSM. HBeAg-negative CHB patients also had more severe distribution of liver inflammation grades than HBeAg-positive patients (p=0.037).

In multivariate analysis, HBeAg negativity was found to be an independent predictor of significant liver fibrosis (p=0.011).

In an earlier study, HBeAg showed no association with the grade of liver inflammation and stage of liver fibrosis in CHB patients with mildly elevated alanine aminotransferase (ALT). In addition, a significant difference was seen in the grade of liver inflammation between HBeAg-positive and HBeAg-negative patients with different HBV DNA levels. [Zhonghua Gan Zang Bing Za Zhi 2012;20:348-352]