Spontaneous seroconversion in hepatitis B e antigen-positive chronic hepatitis B: implications for interferon therapy.
This study compared rates of spontaneous hepatitis B e antigen (HBeAg)-positive to -negative seroconversion in chronic carriers of hepatitis B virus (HBV) with rates reported during interferon-alpha therapy. Four hundred fifty-four Asian-American HBeAg-positive HBV carriers, followed for 1-10 years, were tested approximately every 6 months for HBeAg. Patients with alanine aminotransferase levels > or = 50 IU/mL at entry had 1067.3 seroconversions/10(5) person-months in the 5- to 19-year age group, 1753.3 in the 20- to 34-year group, and 1257.2 in the 35- to 50-year group. Published data indicate that 30% of children and 33% of adults seroconvert during interferon-alpha treatment and follow-up. In our study population, spontaneous seroconversion occurred in 15% of children (95% confidence interval [CI], 8%-27%), 23% of adults 20-34 years (95% CI, 15%-34%), and 17% of adults 35-50 years (95% CI, 10%-28%) during the same interval. The high rate of spontaneous seroconversion should be weighed in decisions to treat HBV carriers with interferon-alpha.
Evans
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AA
Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111, USA.
Fine
M
M
London
W T
WT
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000410:Alanine Transaminase / Q000032:analysis; D001213:Asian; D002353:Carrier State; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D006509:Hepatitis B / Q000453:epidemiology / Q000208:ethnology / Q000276:immunology*; D006510:Hepatitis B Antibodies / Q000032:analysis* / Q000276:immunology*; D006513:Hepatitis B e Antigens / Q000276:immunology*; D006801:Humans; D015994:Incidence; D016898:Interferon-alpha / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016036:Seroepidemiologic Studies
D006510:Hepatitis B Antibodies; D006513:Hepatitis B e Antigens; D016898:Interferon-alpha; D000410:Alanine Transaminase