Chronic Persistent Hepatitis: Serological Classification and Meaning of the Hepatitis B E System

Aldershvile, Jan; Dietrichson, O; Skinhøj, Peter; Kryger, P; Mathiesen, Lars; Christoffersen, Per; Nielsen, Jens

doi:10.1002/hep.1840020209

Cited by 35 publications

(3 citation statements)

References 16 publications

(5 reference statements)

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“…On the other hand, four of seven patients with CPH and HBeAg persistence in our series progressed to CAH, none with delta markers and only one, a homosexual male, suggesting that HBeAg persistence in chronic hepatitis B also implies a more serious prognosis. This is in accordance with the findings of Aldershvile et al (14) who found that 5/1 l patients with CPH and HBeAg persistence progressed to CAH/CI.…”

Section: Discussionsupporting

confidence: 93%

Long‐term follow‐up of 60 patients with chronic hepatitis B. I. Seroconversion in the hepatitis B e‐system, frequency of delta infection and histological outcome

Lindh

Weiland

Svedmyr

et al. 1986

Liver

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ABSTRACT— Sixty patients with liver biopsy documented chronic hepatitis B attending Roslagstull Hospital for Infectious Diseases, Stockholm, Sweden, were followed during a mean period of 53 months (range 7–133 months) in order to evaluate the frequency of delta infection and HBeAg seroconversion as well as the histological outcome as assessed by liver biopsy. Spontaneous HBeAg clearance and development of anti‐HBe occurred among 17 of 36 initially HBeAg positive patients (47%), corresponding to an annual seroconversion rate of 11%. Biochemical improvement was noted in 7/17 patients (41%) after seroconversion as against in 2/19 patients (10.5%) with HBeAg persistence. Superinfection with the delta agent was seen to be associated with severe liver injury among drug addicts and immigrants with chronic hepatitis B. In the absence of a delta infection, progressive liver disease seemed to be associated with persistence of HBeAg. Although none of the homosexual men studied were delta superinfected, 71% developed chronic active hepatitis (CAH) with or without cirrhosis (CI).

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Section: Discussionsupporting

confidence: 93%

Long‐term follow‐up of 60 patients with chronic hepatitis B. I. Seroconversion in the hepatitis B e‐system, frequency of delta infection and histological outcome

Lindh

Weiland

Svedmyr

et al. 1986

Liver

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“…In spite of the great similarity between the two variants of chronic hepatitis (NSRH and CPH), this comparative longitudinal follow-up study has clearly indicated that their clinical courses are different. In keeping with previous reports that CPH is generally a benign, non-progressive disease (18)(19)(20)(21)(22), our data have also indicated that the course in most of the patients with CPH remained stationary during follow-up, and none of them developed CAH or cirrhosis. In contrast, half of the patients with NSRH had fluctuating courses with remarkable biochemical changes and histological features of CLH, or even CAH and/or cirrhosis.…”

Section: Discussionsupporting

confidence: 92%

“…This study also indicates that patients with NSRH can progress to CAH and/or cirrhosis insidiously. Previous studies have also indicated that exceptional cases of CPH can show histological progression to CAH or cirrhosis (19)(20)(21)(22). It is noteworthy that these investigators adopted the classification of de Groote et al (l), and had conceivably classified NSRH as CPH (1,4).…”

Section: Discussionmentioning

confidence: 99%

Chronic hepatitis with nonspecific histological changes. Is it a distinct variant of chronic hepatitis?

Liaw

Sheen

Chu

et al. 1984

Liver

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ABSTRACT— A longitudinal follow‐up study has been undertaken in 62 patients with clinicopathologically verified chronic hepatitis with non‐specific reactive histological changes (NSRH) in comparison with 28 patients with chronic persistent hepatitis (CPH), the clinical features of which are quite similar to NSRH. In contrast to the stationary and non‐progressive course of CPH, 45.2% of patients with NSRH, either HBsAg positive or negative, ran a fluctuating course with moderate to marked elevation of SGPT (>200 IU/l). In HBsAg‐positive patients, only those positive for HBeAg and a few negative for both HBeAg and anti‐HBe had fluctuating courses. In addition, patients with apparent clinical and biochemical changes could show histological features of chronic lobular hepatitis (CLH). A few developed chronic active hepatitis and/or cirrhosis on follow‐up biopsy. It is concluded that NSRH is a form of chronic hepatitis different from CPH, but similar to or representing a phase of CLH. It is suggested that NSRH should be categorized as CLH in the classification of chronic hepatitis.

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Immunosuppressive Treatment of Hbsag–Positive Chronic Liver Disease: Significance of Hbeag

1985

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In a randomized clinical trial in 148 patients of azathioprine vs. prednisone treatment of chronic aggressive hepatitis and/or nonalcoholic cirrhosis, 20 were HBsAg positive on entry. In this subgroup sequential serum samples were investigated for HBs and HBe markers by radioimmunoassay. At the time of evaluation, 13 patients were still alive; their median age was 53 years (25 to 72) and median follow-up time was 46 months (23 to 82). Of 16 patients with cirrhosis, 5 of 7 with persistence of HBeAg died, compared with 2 of 9 with anti-HBe. In three patients with anti-HBe, HBeAg reappeared several times with simultaneous rise in transaminase values. The overall survival was 65% after 5 years. The prognosis of HBsAg-positive chronic liver disease seemed to depend on the presence of cirrhosis and HBeAg rather than on improvement in biochemical activity during immunosuppressive treatment.

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Chronic Persistent Hepatitis: Serological Classification and Meaning of the Hepatitis B E System

Cited by 35 publications

References 16 publications

Long‐term follow‐up of 60 patients with chronic hepatitis B. I. Seroconversion in the hepatitis B e‐system, frequency of delta infection and histological outcome

Long‐term follow‐up of 60 patients with chronic hepatitis B. I. Seroconversion in the hepatitis B e‐system, frequency of delta infection and histological outcome

Chronic hepatitis with nonspecific histological changes. Is it a distinct variant of chronic hepatitis?

Immunosuppressive Treatment of Hbsag–Positive Chronic Liver Disease: Significance of Hbeag

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