title: Outcome of anti-HBe positive chronic hepatitis B in alpha-interferon treated and untreated patients: a long term cohort study.
abstract: OBJECTIVE
  We studied the influence of biochemical and virologic patterns and interferon on the outcome of anti-HBe positive chronic hepatitis B in 164 (103 treated) consecutive patients, followed-up prospectively for a mean of 6 years (21 months-12 years).
  
  
  METHODS
  Histology, biochemical and virologic profiles were characterized by monthly monitoring during the first 12 months of follow-up. Thereafter patients underwent blood and clinical controls every 4 and 6 months, respectively. Cirrhosis at follow-up histology or end stage complications of cirrhosis served as end points for the analysis of factors influencing disease progression in patients with baseline chronic hepatitis or cirrhosis, respectively.
  
  
  RESULTS
  Disease progression was associated with older age (P<0.001), absence of previous HBeAg history (P=0.017) and higher serum HBV-DNA levels (P=0.009) (more frequently observed in unremitting disease profile, P=0.012) at multivariate analysis. Fluctuations of IgM anti-HBc levels (associated with disease exacerbations, P=0.045) correlated with end stage complications in cirrhotics (P=0.011). Disease improved in 14.6 and 1.6% of treated and untreated patients, respectively (P=0.015): interferon slowed disease progression (P<0.001).
  
  
  CONCLUSIONS
  The outcome of anti-HBe positive chronic hepatitis B is worsened by older age and persistent viral replication or hepatitis exacerbations in chronic hepatitis or in cirrhotic patients, respectively. Interferon reduces by 2.5-folds disease progression.
authors.affiliation: U.O. Gastroenterologia ed Epatologia, Spedali Riuniti di Santa Chiara, Via Paradisa n. 2 - Cisanello, 56124 Pisa, Italy. brunetto@med-club.com
authors.forename: Maurizia Rossana
authors.initials: MR
authors.lastname: Brunetto
authors.forename: Filippo
authors.initials: F
authors.lastname: Oliveri
authors.forename: Barbara
authors.initials: B
authors.lastname: Coco
authors.forename: Gioacchino
authors.initials: G
authors.lastname: Leandro
authors.forename: Piero
authors.initials: P
authors.lastname: Colombatto
authors.forename: Juliana Monti
authors.initials: JM
authors.lastname: Gorin
authors.forename: Ferruccio
authors.initials: F
authors.lastname: Bonino
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage*; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006513:Hepatitis B e Antigens / Q000235:genetics; D006515:Hepatitis B virus / Q000235:genetics / Q000254:growth & development*; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage*; D008103:Liver Cirrhosis / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D016896:Treatment Outcome; D014779:Virus Replication
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D016898:Interferon-alpha