Age versus clinical virological characteristics in chronic hepatitis B virus infection: A case series study in China

Objectives This study aimed to investigate the clinical virological characteristics of hepatitis B virus (HBV) in chronic HBV infection patients of different ages, especially in relapse patients and patients with immune clearance. Methods The HBV clinical virological characteristics of chronic HBV infection were investigated in 1572 Chinese patients of different age groups (< 20, 20-40, and > 40 years old). Results Of the patients in the below 20 age group, those with evidence of immune tolerance accounted for 86.05% (P <0.001). Of the patients in the 20-40 age group, those with immune clearance accounted for 36.36% (P <0.001). Of the patients in the above 40 age group, there were markedly more reactivation cases than in any other group (P <0.001). Our data indicated that a positive correlation (r =0.480, P < 0.001) existed between HBV DNA contents (on a log ₁₀ scale) and the alanine aminotransferase (ALT) level of the total cases with reactivation. Of the 300 cases with immune clearance being followed up 10-50 months after enrollment, 181 cases achieved spontaneous hepatitis B e antigen (HBeAg) seroconversion (HBeAg to anti-HBe), and the younger the patient, the shorter the time to seroconversion (P <0.05). Conclusion Generally, there were significantly different HBV clinical virological characteristics in patients with chronic HBV infection of different ages. Different features were observed in relapse patients and patients with immune clearance at different ages, and these two types of patients needed antiretroviral therapy. Our study suggests that revisions of the timing and elevated alanine aminotransferase standards for chronic hepatitis B antiretroviral therapy in Chinese relapse patients and patients with immune clearance in different age groups are warranted.