Characterization of viral kinetics in patients with hepatitis B e antigen-positi

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J Med Virol. 2007 Apr 24;79(6):663-669 [Epub ahead of print]

Characterization of viral kinetics in patients with hepatitis B e

antigen-positive chronic hepatitis B.

Wu IC, Chow NH, Cheng PN, Liu WC, Young KC, Chang WL, Chen CY, Tseng KC,

Chang TT.

Department of Internal Medicine, National Cheng Kung University Hospital,

Tainan, Taiwan.

A study was conducted during a 1 year follow-up to characterize the viral

kinetics in hepatitis B e antigen (HBeAg)-positive chronic hepatitis B and

to develop a model of predicting the probability of spontaneous HBeAg

seroconversion. Fifty-seven patients with HBeAg-positive chronic hepatitis B

were enrolled with monthly follow-ups from three Phase III clinical trial

placebo groups. According to serial viral loads, 30 patients (52.6%) with

the stationary pattern maintained stable HBV DNA levels with fluctuations of

less than 1.5 log copies/ml. Twenty patients (35.1%) with the declining

pattern exhibited a spontaneous decline of more than 1.5 log copies/ml

without a following rebound of at least 1.5 log copies/ml. The remaining

seven patients (12.3%) had the wavering pattern. Both declining and wavering

patterns, when compared with the stationary pattern, had significantly

higher hepatic necroinflammation in terms of ALT and Knodell scores at the

baseline and peak ALT levels during the follow-up period. The declining

pattern had a significantly better clinical outcome in terms of the lowest

final HBV DNA and a reduction in the necroinflammatory score after 1 year.

Furthermore, the declining pattern had a favorable HBeAg seroconversion rate

(40%) compared with the wavering (14.3%) and stationary patterns (0%). A

regression equation, incorporating simultaneous serum bilirubin, ALT, and

HBV DNA levels, predicted the probability of HBeAg seroconversion with a

sensitivity of 76.8% and a specificity of 74.7%. In conclusion, different

viral kinetic patterns in patients with chronic hepatitis B implicate

distinct clinical significance and immunologic perspective. J. Med. Virol.

79: 663-669, 2007. © 2007 Wiley-Liss, Inc.

PMID: 17457902 [PubMed - as supplied by publisher]

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