[Basic factors affecting the development of chronic hepatitis B virus infection].
The authors followed up for a period of five years 276 convalescents after viral hepatitis B where all remained carriers of HBsAg. The group comprised 108 cases of chronic persisting hepatitis, 134 cases of chronic active hepatitis, 13 cirrhoses of the liver and 21 symptom-free carriers of HBsAg. In the group of chronic active hepatitis at the onset of the investigation 128 were HBeAg positive. In the course of five years in 43 patients seroconversion to HBeAg negativity occurred. Thus an annual index of seroconversion from HBeAg of 6.7% was recorded. In the course of five years in 38 patients of 128 HBeAg positive ones an acute relapse was observed. The causes of the relapse were explained by detailed serological examination. Superinfection with the hepatitis A virus participated three times (7.9%), probable superinfection with the hepatitis non-A non-B virus six times (15.8%), superinfection with the EB virus three times (7.9%), superinfection with cytomegalovirus twice (5.3%), seroconversion HBeAg to anti-HBe 14 times (36.8%), discontinuation of corticotherapy six times (15.8%), superinfection with the delta virus in none of the patients and relapses due to other causes four times (10.5%). Seroconversion of HBeAg to anti-HBe was in cca one third of the patients associated with acute exacerbation of the hepatic process. These relapses were, however, transient and their regression was followed by a further improvement of the chronic inflammation. Also relapses after discontinuation of corticotherapy usually improved spontaneously after a certain time interval. When the cause of the relapse was superinfection with the EB virus or cytomegalovirusas as a rule acceleration and further progress of the inflammatory process occurred.
Jezek
P
P
Klinika infekcních chorob Masarykovy univerzity, Brno.
Chalupa
P
P
D002353:Carrier State; D002908:Chronic Disease; D006509:Hepatitis B / Q000209:etiology / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006521:Hepatitis, Chronic / Q000209:etiology / Q000276:immunology; D006801:Humans; D012307:Risk Factors
D006514:Hepatitis B Surface Antigens