title: Prediction of early HBeAg seroconversion by decreased titers of HBeAg in the serum combined with increased grades of lobular inflammation in the liver.
abstract: BACKGROUND
  Hepatitis B e antigen (HBeAg) seroconversion is an important hallmark in the natural course of chronic hepatitis B. This study was designed to predict early HBeAg seroconversion within 1 year, by not only biochemical and virological markers, but also pathological parameters in patients with chronic hepatitis B.
  
  
  METHODS
  In a retrospective cohort study, 234 patients with HBeAg were reviewed for demographic, biochemical, virological and pathological data at the time of liver biopsy. Then, the patients who accomplished HBeAg seroconversion within 1 year thereafter were compared with those who did not, for sorting out factors predictive of early HBeAg seroconversion.
  
  
  RESULTS
  Early HBeAg seroconversion occurred in 58 (24.8%) patients. In univariate analysis, factors predictive of early HBeAg seroconversion were: alanine aminotransferase (ALT) (p=0.002), IP-10 (p=0.029), HBsAg (p=0.003), HBeAg (p<0.001), HBV DNA (p=0.001), HBcrAg (p=0.001), core-promoter mutations (p=0.040), fibrosis (p=0.033) and lobular inflammation (p=0.002). In multivariate analysis, only serum HBeAg levels <100 Paul Ehrlich Institute (PEI) U/ml and grades of lobular inflammation ≥2 were independent factors for early HBeAg seroconversion (odds ratio 8.430 [95% confidence interval 4.173-17.032], p<0.001; and 4.330 [2.009-9.331], p<0.001; respectively).
  
  
  CONCLUSIONS
  HBeAg levels < 100 PEIU/ml combined with grades of lobular inflammation ≥2 are useful for predicting early HBeAg seroconversion. In patients without liver biopsies, high ALT levels (≥200 IU/L) can substitute for lobular inflammation (grades ≥2).
authors.affiliation: Clinical Research Center, National Hospital Organization, Nagasaki Medical Center, Nagasaki, Japan.
authors.forename: Sung Kwan
authors.initials: SK
authors.lastname: Bae
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yatsuhashi
authors.forename: Satoru
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Motoyoshi
authors.forename: Eisuke
authors.initials: E
authors.lastname: Ozawa
authors.forename: Shinya
authors.initials: S
authors.lastname: Nagaoka
authors.forename: Seigo
authors.initials: S
authors.lastname: Abiru
authors.forename: Atsumasa
authors.initials: A
authors.lastname: Komori
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Migita
authors.forename: Minoru
authors.initials: M
authors.lastname: Nakamura
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ito
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Miyakawa
authors.forename: Hiromi
authors.initials: H
authors.lastname: Ishibashi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D002648:Child; D003710:Demography; D005260:Female; D006513:Hepatitis B e Antigens / Q000097:blood*; D019694:Hepatitis B, Chronic / Q000097:blood / Q000276:immunology / Q000821:virology; D006801:Humans; D007249:Inflammation / Q000276:immunology* / Q000473:pathology*; D008099:Liver / Q000276:immunology / Q000473:pathology* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012372:ROC Curve; D012307:Risk Factors; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D015415:Biomarkers; D006513:Hepatitis B e Antigens