Hepatitis B virus deoxyribonucleic acid in serum during hepatitis B e antigen clearance in corticosteroid-treated severe chronic active hepatitis B.
The relationship between hepatitis B virus deoxyribonucleic acid in serum and histologic activity was determined in 11 patients with corticosteroid-treated severe chronic active hepatitis B who underwent clearance of hepatitis B e antigen. All patients cleared hepatitis B virus deoxyribonucleic acid from the serum, and clearance preceded the loss of hepatitis B e antigen by 9-49 mo (mean 24 +/- 4 mo). Seropositivity for hepatitis B virus deoxyribonucleic acid was always associated with histologic features of chronic active hepatitis. Resolution of histologic activity followed the loss of hepatitis B virus deoxyribonucleic acid from the serum and it preceded clearance of hepatitis B e antigen in all patients. A transient elevation of serum aspartate aminotransferase activity occurred in 5 patients at the time that absence of hepatitis B virus deoxyribonucleic acid in serum was first demonstrated, and it was followed by resolution of histologic activity. The serum level of hepatitis B virus deoxyribonucleic acid slowly decreased or remained unchanged in all but 1 patient during long-term corticosteroid therapy. We conclude that hepatitis B virus deoxyribonucleic acid in serum is associated with histologic activity in corticosteroid-treated patients with severe chronic active hepatitis B. Disappearance of hepatitis B virus deoxyribonucleic acid from the serum precedes the loss of histologic activity and clearance of hepatitis B e antigen. Serum hepatitis B virus deoxyribonucleic acid levels usually do not increase during long-term corticosteroid therapy.
Wood
J R
JR
Department of Medicine, Mayo Clinic, Rochester, Minnesota 55905.
Czaja
A J
AJ
Taswell
H F
HF
Ludwig
J
J
Rakela
J
J
Chase
R
R
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use; D004279:DNA, Viral / Q000097:blood*; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000188:drug therapy* / Q000276:immunology; D006513:Hepatitis B e Antigens / Q000276:immunology*; D006515:Hepatitis B virus / Q000235:genetics*; D006521:Hepatitis, Chronic / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D001379:Azathioprine; D011241:Prednisone