Symptomatic anti-HBe positive chronic hepatitis B in Taiwan with special reference to persistent HBV replication and HDV superinfection.
Ninety-four patients, who were admitted with symptoms of liver disease and found to be positive for hepatitis B surface antigen and antibody to hepatitis B e antigen (anti-HBe), were examined for hepatitis B virus (HBV) DNA in serum and immunoglobulin antibody to hepatitis B core antigen and liver biopsies were stained for hepatic hepatitis B core antigen. Of 94 patients, 34 (36%) had evidence of HBV replication and 35 (37%) evidence of hepatitis D virus (HDV) superinfection. Most of the latter two groups of patients (greater than 70%) had evidence of chronic active hepatitis or active cirrhosis in their liver biopsies. The majority of these patients (greater than 80%) also had high levels of serum alanine aminotransferase (greater than 200 U/L) during the acute stage of their illness, and suffered from prolonged hepatic inflammation (greater than 1 year). Many of the patients (59%) also experienced frequent (1-6 episodes) relapsing exacerbations during a two-year follow-up period. Thus, persistent replication or reactivation of HBV and HDV superinfection were the two major causes of clinical exacerbations in anti-HBe-positive chronic HBV carriers in Taiwan, and also played an important role in the progression of their liver diseases and unfavorable outcomes.
Wu
J C
JC
Department of Medicine, Veterans General Hospital, Taipei, Taiwan, Republic of China.
Lee
S D
SD
Tsay
S H
SH
Tsai
Y T
YT
Chan
C Y
CY
Huang
Y S
YS
Lo
K J
KJ
Ting
L P
LP
D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000276:immunology* / Q000382:microbiology; D006510:Hepatitis B Antibodies / Q000032:analysis*; D006513:Hepatitis B e Antigens / Q000276:immunology*; D006515:Hepatitis B virus / Q000502:physiology; D003699:Hepatitis D / Q000150:complications; D006521:Hepatitis, Chronic / Q000276:immunology* / Q000382:microbiology / Q000473:pathology; D006801:Humans; D008297:Male; D013624:Taiwan; D014779:Virus Replication
D006510:Hepatitis B Antibodies; D006513:Hepatitis B e Antigens