Efficacy of a Chinese herbal formula on hepatitis B e antigen-positive chronic hepatitis B patients

Figure 1 Study flowchart.

Figure 2 Concentration curves of hepatitis B virus surface antigen and hepatitis B e antigen levels during Chinese herbal formula and placebo treatment. There was no significant difference between the two groups in serum hepatitis B virus surface antigen or hepatitis B e antigen levels at baseline. A: The patients in the treatment group showed significantly decreased hepatitis B virus surface antigen level in serum compared with those in the control group at weeks 48 and 96; B: The patients in the treatment group showed significantly decreased hepatitis B e antigen level in serum compared with those in the control group at weeks 48 and 96. Mann-Whitney U test. Treatment group: Chinese herbal formula invigorating kidney and clearing away the heat and expelling superficial evils; Control group: Placebo. HBeAg: Hepatitis B e antigen; HBsAg: Hepatitis B surface antigen; ICE: Invigorating kidney and clearing away the heat and expelling superficial evils.

Figure 3 Serum levels of interferon-γ, interleukin-2, interleukin-4 and interleukin-10 were determined by ELISA. A: The patients in the treatment group showed significantly increased interferon-γ levels in serum compared with the placebo group; B: The patients in the treatment group showed significantly increased interleukin (IL)-2 levels in serum compared with the placebo group; C: The patients in the treatment group showed significantly decreased IL-4 levels in serum compared with the placebo group; D: The patients in the treatment group showed significantly decreased IL-10 levels in serum compared with the placebo group. Serum levels of interferon-γ, IL-2, IL-4 and IL-10 were compared between the subgroup weeks 48 and 96. Mann-Whitney U test. Treatment group: Chinese herb formula invigorating kidney and clearing away the heat and expelling superficial evils; Control group: Placebo. IL: Interleukin; IFN-γ: interferon-γ; ICE: Invigorating kidney and clearing away the heat and expelling superficial evils.

Figure 4 Percentage of hepatitis B virus surface antigen and hepatitis B e antigen clearance. Percentage of hepatitis B virus surface antigen and hepatitis B e antigen clearance among patients stratified by baseline, week 24 and week 36 hepatitis B e antigen and hepatitis B virus surface antigen levels; week 36 hepatitis B e antigen change from baseline; weeks 24 and 36 hepatitis B virus surface antigen change from baseline; and week 24 alanine aminotransferase elevation. HBeAg: Hepatitis B e antigen; HBsAg: Hepatitis B surface antigen; ALT: Alanine aminotransferase.

Figure 5 Typical case 1 (pathology No. liver 0372). A: Focal necrosis in hepatic lobules with inflammatory cell infiltration (G1); B: Perisinusoidal fibrosis and lobular fibrosis (S1); C: Hepatitis B virus surface antigen (+++) in one immunohistochemistry assay of liver; D: Hepatitis B virus core antigen (+) in one immunohistochemistry assay of liver; E: Hepatitis B virus surface antigen (-) in two immunohistochemistry assays of liver; F: Hepatitis B virus core antigen (-) in two immunohistochemistry assays of liver.

Figure 6 Typical case 2 (pathology No. liver 0178). A: Extensive necrosis involving multiple lobules and bridging necrosis at low magnification (G4); B: Necrotic cellular debris at high magnification (G4); C: Limited fusion necrosis in two immunohistochemistry assays of liver at low magnification (G3); D: Limited fusion necrosis in two immunohistochemistry assays of liver at high magnification (G3); E: Hepatitis B virus surface antigen (+) in one immunohistochemistry assay of liver; F: Hepatitis B virus surface antigen (-) in two immunohistochemistry assays of liver.

Figure 7 Changes in Knodell histological activity index score, Ishak fibrosis score, liver hepatitis B surface antigen levels and liver hepatitis B core antigen levels at 96 wk after administration in the two groups. A: Knodell histological activity index score; B: Ishak fibrosis score; C: Liver hepatitis B surface antigen levels; D: Liver hepatitis B core antigen levels. HAI: Histological activity index; HBsAg: Hepatitis B surface antigen; HBcAg: Hepatitis B core antigen.