Abstract：
BACKGROUND & AIMS:Predictors of reactivation of hepatitis B following hepatitis B e antigen (HBeAg) seroconversion in chronic hepatitis B have rarely been reported before and deserve further study. METHODS:A total of 133 HBeAg-positive asymptomatic carriers who have undergone HBeAg seroconversion were studied. Reactivation of hepatitis B was defined as elevation of alanine aminotransferase >2 x upper normal limit accompanied by serum hepatitis B virus DNA detectable by hybridization assays. RESULTS:The samples consisted of 75 men and 58 women, and the mean age at entry was 28.2 +/- 6.9 years. One hundred eight subjects had genotype B, and 25 had genotype C. The maximal alanine aminotransferase levels during the HBeAg-positive phase were <2, 2-5, and >5 x upper normal limit in 49, 40, and 44 subjects, respectively. HBeAg seroconversion occurred after a mean follow-up of 4.6 +/- 3.7 years. During a mean follow-up of 5.8 +/- 4.6 years following HBeAg seroconversion, reactivation of hepatitis B occurred in 26 patients at 3.3% per year. Multivariate analyses demonstrated that reactivation of hepatitis B correlated significantly with genotype C (P = .003), male sex (P = .03), alanine aminotransferase levels >5 x upper normal limit during the HBeAg-positive phase (P = .02), and age at HBeAg seroconversion >/=40 years (P = .002). CONCLUSIONS:At baseline, genotype C and male sex are independent factors predictive of reactivation of hepatitis B. Additionally, the likelihood of reactivation of hepatitis B is increased if more rigorous immune-mediated hepatocytolysis or more prolonged immune clearance phase is necessary to eliminate the virus.
journal_name
Gastroenterologyjournal_title
Gastroenterologyauthors
Chu CM,Liaw YFdoi
10.1053/j.gastro.2007.08.039subject
Has Abstractpub_date
2007-11-01 00:00:00pages
1458-65issue
5eissn
0016-5085issn
1528-0012pii
S0016-5085(07)01495-3journal_volume
133pub_type
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