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Spontaneous hepatitis B surface antigen clearance in a long-term follow-up study of patients with chronic type B hepatitis. Lack of correlation with hepatitis C and D virus superinfection

  • Liver, Pancreas, and Biliary Tract
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Abstract

We investigated the frequency of HBsAg clearance and the possible role of viral superinfection in a long-term follow-up of 184 patients with chronic hepatitis B (CHB). Our subjects were 184 patients with chronic hepatitis B and the follow-up was 12–216 months (mean 66.2±53.7 months). The investigative methods used were: immunoenzymatic assays for HBV, HCV, HDV, and HIV markers; polymerase chain reaction (PCR) for HBV DNA; and liver biopsy and immunoperoxidase. During the follow-up, 20 of the 184 patients cleared serum HBsAg. A comparison of patients with persistent HBsAg (group I) and of those who cleared this marker (group II) showed a significant difference in mortality (P=0.002) between the two groups and a tendency to a more severe exacerbation (flare) in group II (P=0.07). Antibodies to hepatitis C and D virus as well as antibodies to HIV were equally distributed in both groups. Thirteen patients (7.9%) from group I, but none from group II, subsequently developed hepatocellular carcinoma. These results suggest that the frequency of spontaneous clearance of HBsAg during chronic HBV infection is low. No determinant factor for the clearance was found, including the presence of liver cirrhosis. Serum HBV DNA was undetectable by PCR after clearance in 16 out of 17 patients.

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Authors and Affiliations

  1. Department of Gastroenterology (Hepatology Branch), University of São Paulo School of Medicine, São Paulo, Brazil

    Luiz Caetano Da Silva, Carmen Lúcia De Assis Madruga, Flair José Carrilho, Luís Edmundo Pinto Da Fonseca & Alex Vianey Callado França

  2. Department of Pathology, University of São Paulo School of Medicine, São Paulo, Brazil

    Venâncio Avancini Ferreira Alves, Regina Leitão, Regina Vianna & Luiz Carlos Da Costa Gayotto

  3. Department of Pro-Sangue Foundation, University of São Paulo School of Medicine, São Paulo, Brazil

    João Renato Rebello Pinho, Amadeo Saéz-Alquezar, Carlos Santos, Leda Bassit & Claudia Barreto

  4. Institute of Tropical Medicine (LIM-47 and 52), University of São Paulo School of Medicine, São Paulo, Brazil

    Luiz Caetano Da Silva, Carmen Lúcia De Assis Madruga, Flair José Carrilho, João Renato Rebello Pinho, Luís Edmundo Pinto Da Fonseca, Rita Antonelli Cardoso & Alex Vianey Callado França

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  1. Luiz Caetano Da Silva
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Da Silva, L.C., De Assis Madruga, C.L., Carrilho, F.J. et al. Spontaneous hepatitis B surface antigen clearance in a long-term follow-up study of patients with chronic type B hepatitis. Lack of correlation with hepatitis C and D virus superinfection. J Gastroenterol 31, 696–701 (1996). https://doi.org/10.1007/BF02347619

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  • DOI: https://doi.org/10.1007/BF02347619

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