title: Clearance of hepatitis B surface antigen in chronic carriers of hepatitis delta antibodies.
abstract: OBJECTIVE
  We evaluated the rate of seroclearance of the hepatitis B surface antigen (HBsAg) and its clinical significance in patients with chronic hepatitis delta virus (HDV).
  
  
  METHODS
  Antibody to HDV was tested in HBsAg-positive subjects admitted to our Hospital from 1991 to 1995. In 1997, a biochemical and virologic study was performed in the surviving anti-HD-positive patients who had not undergone transplantation. As a control, a cohort of 106 HBsAg-positive, anti-HD-negative patients was studied.
  
  
  RESULTS
  One hundred and forty-one subjects were originally positive for anti-HD. After 4 years of follow-up, six of the 60 patients who underwent re-evaluation (10%) had cleared the HBsAg: three of the six patients had minimal changes at the initial liver histology and normal ALT, whereas in the remaining three patients with chronic active hepatitis ALT normalized during the observation. Anti-HD persisted in five of the six patients. Only one patient had raised anti-HBs. In contrast, three of 106 HBsAg carriers without HDV infection (2.8%) cleared the HBsAg within the same time and seroconverted to anti-HBs (p=0.002).
  
  
  CONCLUSIONS
  HBsAg clearance is increased over the years in HDV patients compared to ordinary HBsAg carriers, and is often associated with improvement of HDV disease without seroconversion to anti-HBs.
authors.affiliation: Division of Gastroenterology, San Giovanni Battista Hospital, Turin, Italy. nirograzia@tiscalinet.it
authors.forename: G A
authors.initials: GA
authors.lastname: Niro
authors.forename: E
authors.initials: E
authors.lastname: Gravinese
authors.forename: E
authors.initials: E
authors.lastname: Martini
authors.forename: M
authors.initials: M
authors.lastname: Garrubba
authors.forename: D
authors.initials: D
authors.lastname: Facciorusso
authors.forename: P
authors.initials: P
authors.lastname: Conoscitore
authors.forename: G
authors.initials: G
authors.lastname: Di Giorgio
authors.forename: M
authors.initials: M
authors.lastname: Rizzetto
authors.forename: A
authors.initials: A
authors.lastname: Andriulli
mesh_terms: D002908:Chronic Disease; D006508:Hepatitis Antibodies / Q000276:immunology*; D006509:Hepatitis B / Q000235:genetics / Q000276:immunology*; D006514:Hepatitis B Surface Antigens / Q000276:immunology*; D003698:Hepatitis Delta Virus / Q000235:genetics / Q000276:immunology*; D006579:Heterozygote; D006801:Humans
chemical_list: D006508:Hepatitis Antibodies; D006514:Hepatitis B Surface Antigens