Long-Term Outcome after Hepatitis B Surface Antigen Seroclearance in Patients with Chronic Hepatitis B - 19/08/11
, Kenji Ikeda, MD a, Fumitaka Suzuki, MD a, Yoshiyuki Suzuki, MD a, Satoshi Saitoh, MD a, Masahiro Kobayashi, MD a, Norio Akuta, MD a, Takashi Someya, MD a, Tetsuya Hosaka, MD a, Hitomi Sezaki, MD a, Mariko Kobayashi b, Hiromitsu Kumada, MD a
Requests for reprints should be addressed to Yasuji Arase, MD, Department of Gastroenterology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.Abstract |
Purpose |
The aim of this study was to elucidate the long-term outcome after hepatitis B surface antigen (HBsAg) seroclearance in a large number of Japanese patients.
Methods |
We studied the biochemical, virologic, histologic, and prolonged prognoses of 231 Japanese patients with HBsAg seroclearance (median follow-up, 6.5 years). Serum alanine aminotransferase, serum hepatitis B virus (HBV) markers, liver histology, and clinical aspects were monitored. HBV-DNA levels were measured with the qualitative polymerase chain reaction assay. The mean age of patients with HBsAg seroclearance was 52 years.
Results |
After HBsAg seroclearance, 203 patients (87.9%) had normal alanine aminotransferase levels 1 year after HBsAg seroclearance. HBV-DNA showed positive results in 4 patients (1.7%) 1 year after HBsAg seroclearance. Thirteen patients were examined for histologic changes of the liver after HBsAg seroclearance. All patients showed marked improvement of necroinflammation of the liver, but only 2 of the 13 patients showed no liver fibrosis. Liver cirrhosis and hepatocellular carcinoma did not develop in any of the 164 patients without evidence of liver cirrhosis at the time of HBsAg seroclearance. Hepatocellular carcinoma developed in 2 of the 67 patients with liver cirrhosis at the time of HBsAg seroclearance. During the observation period, 15 patients died. However, the cause of death of these 15 patients was not related to liver disease, such as hepatocellular carcinoma, decompensated liver cirrhosis, and rupture of esophageal varices.
Conclusion |
Our results suggest that HBsAg seroclearance confers favorable long-term outcomes in patients without hepatocellular carcinoma or decompensated liver cirrhosis at the time of HBsAg seroclearance
Le texte complet de cet article est disponible en PDF.Keywords : Chronic hepatitis B, HBV-DNA, Seroclearance of hepatitis B surface antigen
Plan
| The present work was supported in part by grants-in-aid from Okinaka Memorial Institute for Medical Research and Japanese Ministry of Health, Labor, and Welfare. |
Vol 119 - N° 1
P. 71.e9-71.e16 - janvier 2006 Retour au numéro
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