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Long‐term follow‐up of anti‐HBe‐positive chronic active hepatitis B
Author(s) -
Fattovich Giovanna,
Brollo Lucio,
Alberti Alfredo,
Pontisso Patrizia,
Giustina Giuliano,
Realdi Giuseppe
Publication year - 1988
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840080630
Subject(s) - medicine , cirrhosis , hepatitis , liver biopsy , hepatitis b virus , virus , hepatitis b , virology , gastroenterology , serology , immunology , biopsy , antibody
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.