Objective: To explore the association of HBeAg positivity and alpha fetoprotein (AFP) level with the prognosis of chronic severe hepatitis B.
Methods: A total of 325 hospitalized patients with chronic severe hepatitis B were analyzed for serum HBeAg positivity and AFP levels and their association with the prognosis.
Results: Of all the 325 patients, 168 (51.7%) were HBeAg-positive and 157 (48.3%) were HBeAg-negative, and the two groups showed no significant difference in gender distribution, average peak value of total bilirubin and average trough prothrombin activity. Compared with the positive patients, the HBeAg-negative patients had significantly older age (P < 0.001), higher rate of liver cirrhosis (P < 0.001) and lower response rate (P < 0.05). Elevated AFP level was positively correlated to the response rate in both the HBeAg-positive (P < 0.001) and negative patients (P < 0.05).
Conclusions: HBeAg-negative patients with chronic severe hepatitis B have poorer prognosis than the HBeAg-positive patients, and higher AFP levels are associated with more favorable prognosis regardless of the HBeAg positivity.