title: Frequent reactivations of anti-HBe-positive chronic hepatitis B in patients with no demonstrable HBV DNA in serum by polymerase chain reaction.
abstract: OBJECTIVE
  The present study was conducted to evaluate the prognostic significance of the absence of serum HBV DNA by polymerase chain reaction (PCR) after spontaneous HBeAg/anti-HBe seroconversion and concurrent or subsequent biochemical remission.
  
  
  METHODS
  We prospectively investigated the reactivation rates in 28 chronic hepatitis B patients according to the positive or negative serum HBV DNA test by PCR. The sera drawn at a mean period of 4.4 months after normalization of alanine aminotransferase (ALT) were analyzed by PCR-Southern blot hybridization to detect HBV DNA, and then the patients were divided into two groups according to the presence (n = 14) or absence (n = 14) of HBV DNA in the sera.
  
  
  RESULTS
  The cumulative reactivation rates in patients with HBV DNA in sera were 43%, 57%, 57%, 57% and 57% at the end of 1st, 2nd, 3rd, 4th and 5th year after normalization of ALT, respectively, and those in patients without demonstrable HBV DNA were 50%, 66%, 74%, 74% and 83%, respectively; thus, the difference in the cumulative reactivation rates between patients with and without serum HBV DNA was not statistically significant (p = 0.79), and irrespective of the status of HBV DNA in sera by PCR, reactivations occurred very rarely after 2 years of a sustained remission.
  
  
  CONCLUSIONS
  We conclude that the seroconversion to anti-HBe accompanied by disappearance of serum HBV DNA even by PCR does not necessarily suggest a sustained remission of chronic hepatitis B.
mesh_terms: D000328:Adult; D002908:Chronic Disease; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D006509:Hepatitis B / Q000276:immunology / Q000821:virology*; D006510:Hepatitis B Antibodies / Q000097:blood*; D006513:Hepatitis B e Antigens / Q000276:immunology*; D006515:Hepatitis B virus / Q000235:genetics*; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D014775:Virus Activation
chemical_list: D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006513:Hepatitis B e Antigens