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Date Published: 13/11/2023
Abstract Views: 6418
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DOI: https://doi.org/10.59873/vjid.v3i43.300
Issue
Vol. 3 No. 43 (2023): Tạp chí Truyền nhiễm Việt Nam
Section
Scientific research
How to Cite
Tu Le Thanh, T., Le Manh, H., Pham Tran Dieu, H., Dao Bach, K., Le Thanh, P., Nguyen Thi Hong, L., Huỳnh Thi Thuy, H., Ho Dang Trung, N., Ha, V., & Du Trong, D. (2023). DIFFERENTIATION OF ACUTE EXACERBATIONS OF CHRONIC HEPATITIS B AND ACUTE HEPATITIS B IN ANTI-HBc IgM POSITIVE PATIENTS AT HOSPITAL FOR TROPICAL DISEASES. Vietnam Journal of Infectious Diseases, 3(43), 8-14. https://doi.org/10.59873/vjid.v3i43.300

DIFFERENTIATION OF ACUTE EXACERBATIONS OF CHRONIC HEPATITIS B AND ACUTE HEPATITIS B IN ANTI-HBc IgM POSITIVE PATIENTS AT HOSPITAL FOR TROPICAL DISEASES

Thao Tu Le Thanh, Hung Le Manh, Hien Pham Tran Dieu, Khoa Dao Bach, Phuong Le Thanh, Lan Nguyen Thi Hong, Hoa Huỳnh Thi Thuy, Nghia Ho Dang Trung, Vinh Ha, Duc Du Trong

Main Article Content

Abstract

Background: Acute exacerbations of chronic hepatitis B (CHB-AE) are common in endemic areas and difficult to distinguish from acute hepatitis B (AHB) in anti-HBc IgM-positive patients with prior HBV history infection is unknown.


Objectives: To identify the factors that differentiate AHB from CHB-AE in anti-HBc IgM-positive patients.


Methods: A retrospective and prospective analysis of record was conducted for patients who presented with clinical features of acute hepatitis along with IgM antibody to hepatitis B core antigen (anti-HBc IgM) positive at Hospital for Tropical Diseases (HTD) from January 2018 to September 2022. Diagnostic confirmed based on HBsAg loss after 6 months. Multivariates logistic regression was done to identify the factors that differentiated these two features.


Results: A total of 610 patients were enrolled and divided into two groups: AHB (n = 491) and CHBAE (n = 119). The level of platelet, TQ, ALT, albumin and the value of S/CO ratio for anti-HBc IgM were significantly lower in the CHB-AE group compared to the AHB group. In contrast, age, the level of AFP, the value of S/CO ratio for HBeAg and HBV DNA had higher levels in the CHB-AE group. The multivariate analysis demonstrated that the level of platelet, AFP and the S/CO ratio of anti-HBc IgM were meaningful factors.


Conclusions: Anti-HBc IgM should be included concurrently with the test of liver fibrosis such as the level of platelet and AFP to predict patients with CHB-AE.

Article Details

Keywords

Differential diagnosis, acute hepatitis B, acute exacerbation of chronic hepatitis B, hepatitis B virus, anti-HBc IgM

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