TY - JOUR
T1 - Outcome of anti-HBe positive chronic hepatitis B in alpha-interferon treated and untreated patients
T2 - A long term cohort study
AU - Brunetto, Maurizia Rossana
AU - Oliveri, Filippo
AU - Coco, Barbara
AU - Leandro, Gioacchino
AU - Colombatto, Piero
AU - Gorin, Juliana Monti
AU - Bonino, Ferruccio
PY - 2002
Y1 - 2002
N2 - Background/Aims: We studied the influence of biochemical and virologic patterns and interferon on the outcome of anti-HBe positive chronic hepatitis B in 164 (103 treated) consecutive patients, followed-up prospectively for a mean of 6 years (21 months-12 years). Methods: Histology, biochemical and virologic profiles were characterized by monthly monitoring during the first 12 months of follow-up. Thereafter patients underwent blood and clinical controls every 4 and 6 months, respectively. Cirrhosis at follow-up histology or end stage complications of cirrhosis served as end points for the analysis of factors influencing disease progression in patients with baseline chronic hepatitis or cirrhosis, respectively. Results: Disease progression was associated with older age (P <0.001), absence of previous HBeAg history (P = 0.017) and higher serum HBV-DNA levels (P = 0.009) (more frequently observed in unremitting disease profile, P = 0.012) at multivariate analysis. Fluctuations of IgM anti-HBc levels (associated with disease exacerbations, P = 0.045) correlated with end stage complications in cirrhotics (P = 0.011). Disease improved in 14.6 and 1.6% of treated and untreated patients, respectively (P = 0.015): interferon slowed disease progression (P <0.001). Conclusions: The outcome of anti-HBe positive chronic hepatitis B is worsened by older age and persistent viral replication or hepatitis exacerbations in chronic hepatitis or in cirrhotic patients, respectively. Interferon reduces by 2.5-folds disease progression.
AB - Background/Aims: We studied the influence of biochemical and virologic patterns and interferon on the outcome of anti-HBe positive chronic hepatitis B in 164 (103 treated) consecutive patients, followed-up prospectively for a mean of 6 years (21 months-12 years). Methods: Histology, biochemical and virologic profiles were characterized by monthly monitoring during the first 12 months of follow-up. Thereafter patients underwent blood and clinical controls every 4 and 6 months, respectively. Cirrhosis at follow-up histology or end stage complications of cirrhosis served as end points for the analysis of factors influencing disease progression in patients with baseline chronic hepatitis or cirrhosis, respectively. Results: Disease progression was associated with older age (P <0.001), absence of previous HBeAg history (P = 0.017) and higher serum HBV-DNA levels (P = 0.009) (more frequently observed in unremitting disease profile, P = 0.012) at multivariate analysis. Fluctuations of IgM anti-HBc levels (associated with disease exacerbations, P = 0.045) correlated with end stage complications in cirrhotics (P = 0.011). Disease improved in 14.6 and 1.6% of treated and untreated patients, respectively (P = 0.015): interferon slowed disease progression (P <0.001). Conclusions: The outcome of anti-HBe positive chronic hepatitis B is worsened by older age and persistent viral replication or hepatitis exacerbations in chronic hepatitis or in cirrhotic patients, respectively. Interferon reduces by 2.5-folds disease progression.
KW - Chronic viral hepatitis
KW - HBeAg minus HBV
KW - Hepatitis B virus
KW - Hepatitis exacerbation
KW - Interferon
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U2 - 10.1016/S0168-8278(01)00266-5
DO - 10.1016/S0168-8278(01)00266-5
M3 - Article
C2 - 11830339
AN - SCOPUS:0036168816
VL - 36
SP - 263
EP - 270
JO - Journal of Hepatology
JF - Journal of Hepatology
SN - 0168-8278
IS - 2
ER -