This study aimed to measure and compare serum factor V activity and the serum ammonia level in chronic hepatitis B patients with and without acute exacerbation of chronic hepatitis B infection. Patients were divided into the following 2 groups: group 1 consisted of 67 patients with chronic hepatitis B infection without exacerbation; group 2 consisted of 67 patients with acute exacerbation of chronic hepatitis B infection. The serum level of ALT, AST, ammonia, and serum factor V activity were measured and compared between groups. Mean age in group 1 was 38 years and the mean laboratory findings were as follows: serum ALT: 32.3 ± 17.3 U L–1; factor V activity: 112.42% ± 22.67%; ammonia: 13.85 ± 8.32 µg mL–1. Mean age in group 2 was 34 years and the mean laboratory findings were as follows: serum ALT: 1087.2 ± 911.9 U L–1; factor V activity: 101.13% ± 32.65%; ammonia: 34.20 ± 42.35 µg mL–1. Factor V activity was significantly lower in group 2 (P ≤ 0.022) and the serum ammonia level was significantly higher in group 2 (P = 0.0001). In the patients with hepatic exacerbation the serum ammonia level was higher, independent of the presence of hepatic encephalopathy in the absence of hepatic cirrhosis or hepatic failure, and was indicative of hepatic damage. Low serum factor V activity in the patients with hepatic exacerbation indicate insufficient liver regeneration capacity.
Chronic hepatitis B, Ammonia, Factor V activity