Chronic Hepatitis B Virus Carriers in the Immunotolerant Phase of Infection: Histologic Findings and Outcome
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- 作者：Tony Andreani?/sup> ; tony.andreani@wanadoo.fr ; Lawrence Serfaty?/sup> ; Djamila Mohand?/sup> ; Salem Dernaika?/sup> ; Dominique Wendum&Dagger ; ; Olivier Chazouillè ; res?/sup> ; Raoul Poupon?/sup>
- 关键词：anti-HBe ; antibody to hepatitis B e antigen ; BMI ; body mass index ; HBeAg ; hepatitis B e antigen ; HBsAg ; hepatitis B surface antigen ; HBV ; hepatitis B virus ; ULN ; upper limit of normal
- 刊名：Clinical Gastroenterology and Hepatology
- 出版年：2007
- 出版时间：May 2007
- 年：2007
- 卷：5
- 期：5
- 页码：636-641
- 全文大小：222 K
文摘
Background & Aims: The indication for histologic evaluation of the liver is controversial for patients in the immunotolerant phase of chronic hepatitis B virus (HBV) infection. Methods: Results of liver biopsy examination and follow-up evaluation were assessed retrospectively in 40 patients who satisfied the following criteria: presence of hepatitis B surface antigen and hepatitis B e antigen, HBV DNA level greater than 107 cp/mL, normal alanine aminotransferase level, absence of co-infection with other viruses, and absence of antiviral or immunosuppressive treatment. Results: On liver biopsy examination, according to the Metavir scoring system, fibrosis was absent in 20 patients, and mild (F1) in 20 patients. During a median follow-up period of 37.7 months in 31 patients, loss of tolerance was observed at a median age of 30.7 years in 12 (38 % ): 6 had transition to inactive disease, 3 developed chronic hepatitis, and 3 had a transient increase of alanine aminotransferase levels. Among baseline characteristics, only alanine aminotransferase levels were significantly higher in patients with subsequent loss of tolerance. Conclusions: In patients in the immunotolerant phase of chronic HBV infection, liver biopsy examination shows only minimal changes and probably is unnecessary. Loss of tolerance, occurring at a median age of 30.7 years, is characterized by a rapid transition to an inactive carrier state in two thirds of patients, and to chronic hepatitis in one third of patients.