Spontaneous relapse of hepatitis in inactive HBsAg carriers
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The issue of spontaneous relapse of hepatitis in anti-HBe positive asymptomatic HBsAg carriers was rarely reported before and deserves further exploration.
A total of 1241 anti-HBe positive asymptomatic adult HBsAg carriers were prospectively followed up. Of these, 661 (53%) were males, and the mean (±SD) age was 35.6 ± 9.1 years. Relapse of hepatitis was defined as elevation of ALT more than twice the upper limit of normal accompanied by detectable serum HBV DNA by hybridization assays.
During a mean follow up of 12.3 years, hepatitis relapsed in 211 patients with an annual rate of 1.46%. The cumulative probabilities of hepatitis relapse were 10.2%, 17.4%, 19.3%, 20.2%, and 20.2%, respectively, after 5, 10, 15, 20, and 25 years of follow up. Multivariate analyses showed that the probability of hepatitis relapse correlated significantly with male sex (P < 0.0001) and age at entry (P = 0.007). The cumulative probability of hepatitis relapse after 20 years was 26.9% for males and only 12.5% for females, and was 13.1% for those of age <30 years at entry but increased to 29.4% for those of age 40–49 years at entry.
Hepatitis relapsed in about 20% of asymptomatic HBsAg carries during 25 years of follow up. Relapse of hepatitis occurred more frequently during earlier years of follow up. Males were more likely to have relapse of hepatitis than females. In addition, relapse of hepatitis was significantly less frequent in patients who were younger than 30 years at study entry, possibly implicating more favorable outcome of earlier HBeAg seroconversion.
- Chu CM, Liaw YF. Natural history differences in perinatally versus adult-acquired disease. Curr Hepatitis Rep 2004;3:123–31. CrossRef
- Chu CM, Karayiannis P, Fowler MJ, Monjardino J, Liaw YF, Thomas HC. Natural history of chronic hepatitis B virus infection in Taiwan: studies of hepatitis B virus DNA in serum. Hepatology 1985;5:431–4. CrossRef
- Chu CM. Natural history of chronic hepatitis B virus infection in adults with emphasis on the occurrence of cirrhosis and hepatocellular carcinoma. J Gastroenterol Hepatol 2000;15 Suppl:E25–30. CrossRef
- Liaw YF, Tai DI, Chu CM, Chen TJ. The development of cirrhosis in patients with chronic type B hepatitis: a prospective study. Hepatology 1988;8:493–6. CrossRef
- Fattovich G, Brollo L, Giustina G, Noventa F, Pontisso P, Alberti A, Realdi G, Ruol A. Natural history and prognostic factors for chronic hepatitis type B. Gut 1991;32:294–8.
- Hsu YS, Chien RN, Yeh CT, Sheen IS, Chiou HY, Chu CM, Liaw YF. Long-term outcome after spontaneous HBeAg seroconversion in patients with chronic hepatitis B. Hepatology 2002;35:1522–7. CrossRef
- Chu CM, Hung SJ, Lin J, Tai DI, Liaw YF. Natural history of hepatitis B e antigen to antibody seroconversion in patients with normal serum aminotransferase levels. Am J Med 2004;116:829–34. CrossRef
- Chu CM, Liaw YF. Genotype C hepatitis B virus infection is associated with a higher risk of reactivation of hepatitis B, progression to cirrhosis than genotype B: a longitudinal study of hepatitis B e antigen-positive patients with normal aminotransferase levels at baseline. J Hepatol 2005;43:411–7. CrossRef
- Chen DS, Sung JL, Lai MY. A seroepidemiologic study of hepatitis B virus infection in Taiwan. Taiwan Yi Xue Hui Za Zhi 1978;77:908–18.
- Wu JS, Chen CH, Chiang YH, Lee YC, Lee MH, Ko YC, Hu HT. Hepatitis B virus infection in Taiwan with reference to anti-HBc versus HBsAg and anti-HBs. Taiwan Yi Xue Hui Za Zhi 1980;79:760–7.
- Sung JL, Chen DS, Lai MY, Yu JY, Wang TH, Wang CY, Lee CY, Chen SY, Ko TM. Epidemiology study on hepatitis B virus infection in Taiwan. Chin J Gastroenterol 1984;1:1–9.
- Chu CM, Sheen IS, Lin SM, Liaw YF. Sex difference in chronic hepatitis B viStudies of serum HBeAg and alanine aminotransferase levels in 10431 asymptomatic Chinese HBsAg carriers. Clin Infect Dis 1993;16:709–13.
- Chu CM, Liaw YF. HBsAg seroclearance in asymptomatic carriers of high endemic areas: appreciably high rates during a long-term follow up. Hepatology 2007;45:1187–1192. CrossRef
- Lin DY, Sheen IS, Chiu CT, Lin SM, Kuo YC, Liaw YF. Ultrasonographic changes of early liver cirrhosis in chronic hepatitis B: a longitudinal study. J Clin Ultrasound 1993;21:303–8. CrossRef
- Kao JH, Chen PJ, Lai MY, Chen DS. Hepatitis B virus genotypes and spontaneous hepatitis B e antigen seroconversion in Taiwanese hepatitis B carriers. J Med Virol 2004;72:363–9. CrossRef
- Yuen MF, Yuan HJ, Wong DK, Yuen JC, Wong WM, Chan AO, Wong BC, Lai KC, Lai CL. Prognostic determinants for chronic hepatitis B in Asians: therapeutic implications. Gut 2005;54:1610–4. CrossRef
- Chu CJ, Hussain M, Lok AS. Hepatitis B virus genotype B is associated with earlier HBeAg seroconversion compared with hepatitis B virus genotype C. Gastroenterology 2002;122:1756–62. CrossRef
- Chu CM, Liaw YF, Sheen IS, Lin DY, Huang MJ. Sex difference in chronic hepatitis B virus infection: an appraisal based on the status of hepatitis B e antigen and antibody. Hepatology 1983;3:947–50. CrossRef
- Iloeje UH, Yang HI, Su J, Jen CL, You SL, Chen CJ. Risk evaluation of viral load elevation and associated liver disease/cancer-In HBV (the REVEAL-HBV) study group. Predicting cirrhosis risk based on the level of circulating hepatitis B viral load. Gastroenterology 2006;130:678–86. CrossRef
- Chen CJ, Yang HI, Su J, Jen CL, You SL, Lu SN, Huang GT, Iloeje UH. REVEAL-HBV Study Group. Risk of hepatocellular carcinoma across a biological gradient of serum hepatitis B virus DNA level. JAMA 2006;295:65–73. CrossRef
- Spontaneous relapse of hepatitis in inactive HBsAg carriers
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