Long-Term Outcome after Hepatitis B Surface Antigen Seroclearance in Patients wi

[Guest guest]

The American Journal of Medicine

Volume 119, Issue 1 , January 2006, Pages 71.e9-71.e16

doi:10.1016/j.amjmed.2005.02.033

AJM Online

Long-Term Outcome after Hepatitis B Surface Antigen Seroclearance in

Patients with Chronic Hepatitis B

Yasuji Arase MDa, , , Kenji Ikeda MDa, Fumitaka Suzuki MDa, Yoshiyuki Suzuki

MDa, Satoshi Saitoh MDa, Masahiro Kobayashi MDa, Norio Akuta MDa, Takashi

Someya MDa, Tetsuya Hosaka MDa, Hitomi Sezaki MDa, Mariko Kobayashib and

Hiromitsu Kumada MDa

aDepartment of Gastroenterology, Toranomon Hospital, Tokyo, Japan

bHepatic Research Unit, Toranomon Hospital, Tokyo, Japan

Received 31 December 2004; revised 11 February 2005; accepted 11 February

2005. Available online 21 January 2006.

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

FULL TEXT AT:

http://www.sciencedirect.com/science?_ob=ArticleURL & _udi=B6TDC-4J37F4N-T & _user=1\

0 & _handle=V-WA-A-W-VV-MsSAYWA-UUA-U-AAVUZAEZDD-AABYWUUVDD-ZUZVYAEWV-VV-U & _fmt=fu\

ll & _coverDate=01%2F31%2F2006 & _rdoc=23 & _orig=browse & _srch=%23toc%235195%232006%23\

998809998%23615320! & _cdi=5195 & view=c & _acct=C000050221 & _version=1 & _urlVersion=0 & _\

userid=10 & md5=bb3810dec2be8f03eb81b1aaeb742b66

_________________________________________________________________

Express yourself instantly with MSN Messenger! Download today - it's FREE!

http://messenger.msn.click-url.com/go/onm00200471ave/direct/01/