Long-term follow-up of anti-HBe-positive chronic active... : Hepatology (original) (raw)
Original Articles: PDF Only
Fattovich, Giovanna M.D.*, 1; Brollo, Lucio1; Alberti, Alfredo1; Pontisso, Patrizia1; Giustina, Giuliano1; Realdi, Giuseppe1
1Istituto di Medicina Clinica, Clinica Medica 2a, Università di Padova, 35100 Padova, Italy
*Address reprint requests to: Istituto di Medicina Clinica, Università di Padova, Via Giustiniani 2, 35100 Padova, Italy.
Received June 11, 1987; Accepted May 28, 1988; previously published online December 06, 2005
Abstract
Twenty-eight patients with chronic active hepatitis without cirrhosis who were positive for hepatitis B surface antigen and antibody to hepatitis B e antigen were followed for 1 to 15 years (mean 6.6 years) and underwent follow-up biopsy. At presentation, 12 of the 28 patients (43%) had hepatitis B virus DNA in serum, 10 (36%) had serologic evidence of hepatitis delta virus infection and 6 (21%) had no serologic markers of either hepatitis B virus replication or hepatitis delta virus infection. During follow-up, 15 (54%) patients developed active cirrhosis, including eight patients with hepatitis delta virus infection and five with hepatitis B virus DNA in serum. In seven (47%) of the 15 patients, cirrhosis developed within the first 2 years; all seven patients had bridging necrosis in the first liver biopsy, and five of these were infected with hepatitis delta virus. The remaining 13 (46%) patients did not develop cirrhosis during follow-up and showed either unchanged features of chronic active hepatitis (seven cases) or histologic improvement to chronic persistent hepatitis (five cases) or to normal liver (one case). In conclusion, the prognosis of anti-HBe-positive patients with chronic hepatitis B is poor, as 54% of the cases developed cirrhosis during a mean histologic follow-up period of 4.5 years, mainly in association with hepatitis delta virus infection or continuing hepatitis B virus replication.
Copyright © 1988 American Association for the Study of Liver Diseases.