Reversibility of cirrhosis in chronic hepatitis B.
OBJECTIVE
Hepatic fibrosis and cirrhosis are the consequences of many types of chronic liver disease, and, at its final stage when liver nodule and scarring develop, they are generally considered to be irreversible.


METHODS
Here we describe 3 patients with chronic hepatitis B with clinical, biochemical, and histologic evidence of cirrhosis. They underwent treatment with interferon-alpha or lamivudine and had follow-up liver biopsy while in clinical, biochemical, and virologic remission. Biopsy specimens were randomly coded in unpaired manner according to patient, and they were read independently by 2 pathologists using the modified hepatitis activity index (with a maximum stage of 6). The mean interval between biopsies was 5.5 years.


RESULTS
The mean ALT level decreased from 113.7 to 28.3 U/L. The mean bilirubin level decreased from 2.4 to 0.9 mg/dL, and the mean prothrombin time decreased from 16.3 to 12.3 seconds. The mean Child-Pugh score decreased from 8 to 5. The mean fibrosis score decreased from 5.8 to 0.5 (P = 0.004), and the mean grading score decreased from 10.8 to 3.2 (P = 0.017).


CONCLUSIONS
Cirrhosis due to chronic hepatitis B might be reversible in some patients who respond to antiviral therapy.
Malekzadeh
Reza
R
Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Iran. malek@ams.ac.ir
Mohamadnejad
Mehdi
M
Rakhshani
Nasser
N
Nasseri-Moghaddam
Siavosh
S
Merat
Shahin
S
Tavangar
Seyed Mohamad
SM
Sohrabpour
Amir Ali
AA
D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage*; D001707:Biopsy, Needle; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage*; D019259:Lamivudine / Q000008:administration & dosage*; D008103:Liver Cirrhosis / Q000473:pathology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D012075:Remission, Spontaneous; D012494:Sampling Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D019259:Lamivudine