Regression of cirrhosis associated with hepatitis B e (HBe) antigen-negative chronic hepatitis B infection with prolonged lamivudine therapy.
In theory, hepatic fibrosis should be a dynamic process with the potential for remodelling after the injury-provoking stimulus has been removed. Clinically, there has been an accumulation of a small number of cases, including hepatitis B e (HBe) antigen-positive chronic hepatitis B infection, in which cirrhosis regressed after successful treatment. We report a 42-year-old HBe antigen-negative Chinese man with detectable serum hepatitis B virus DNA and histologically established cirrhosis (Ludwig score 4) who, after 4 years of successful lamivudine therapy, was found to have regression of cirrhosis on repeat liver biopsy. The repeat biopsy revealed normal liver architecture with fibrosis confined to the portal tracts and short fibrosis septae extending into the lobule without bridging (Ludwig score 1-2). Although cirrhosis may take many years to develop, our experience suggests that successful treatment may reverse the process within a relatively short time.
Yoshida
Eric M
EM
Department of Medicine, University of British Columbia, Vancouver, BC, Canada. eyoshida@interchange.ubc.ca
Ramji
Alnoor
A
Chatur
Nazira
N
Davis
Jennifer E
JE
Owen
David A
DA
D000328:Adult; D004279:DNA, Viral / Q000032:analysis; D006513:Hepatitis B e Antigens / Q000032:analysis*; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000150:complications / Q000473:pathology*; D008134:Long-Term Care / Q000379:methods; D008297:Male; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*
D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine