Predictors of spontaneous viral clearance and outcomes of acute hepatitis C infection
| Autor: | Soo Young Na, Hyun Joo Song, Hye Young Jwa, Yoo Kyung Cho, Heung Up Kim, Sun Jin Boo, Eun Kwang Choi, Byung-Cheol Song, Seung Uk Jeong |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Hepatitis B virus Guanine Exacerbation Genotype medicine.medical_treatment Hepatitis B virus chronic hepatitis B Liver transplantation medicine.disease_cause Gastroenterology Antiviral Agents Hepatitis B Chronic Risk Factors Internal medicine medicine Humans In patient Hepatitis B e Antigens Prospective Studies lcsh:RC799-869 Prospective cohort study Molecular Biology Hepatology biology business.industry virus diseases Alanine Transaminase Jaundice Middle Aged digestive system diseases Alanine transaminase Immunology DNA Viral biology.protein acute exacerbation of hepatitis B HBV genotype lcsh:Diseases of the digestive system. Gastroenterology Original Article Female medicine.symptom Erratum business Follow-Up Studies |
| Zdroj: | Clinical and Molecular Hepatology Clinical and Molecular Hepatology, Vol 20, Iss 4, Pp 355-360 (2014) |
| ISSN: | 2287-285X 2287-2728 |
| Popis: | Background/Aims Spontaneous HBeAg seroconversion occurs frequently in the immune reactive phase in HBeAg-positive chronic hepatitis B (CHB). Therefore, observation for 3-6 months before commencing antiviral therapy is recommended in patients with alanine aminotransferase (ALT) levels that exceed twice the upper limit of normal (ULN). However, HBeAg seroconversion occurs infrequently in patients infected with hepatitis B virus (HBV) genotype C. The aim of the present study was to determine whether the waiting policy is necessary in endemic areas of HBV genotype C infection. Methods Ninety patients with HBeAg-positive CHB were followed prospectively without administering antiviral therapy for 6 months. Antiviral therapy was initiated promptly at any time if there was any evidence of biochemical (i.e., acute exacerbation of HBV infection or aggravation of jaundice) or symptomatic deterioration. After 6 months of observation, antiviral therapy was initiated according to the patient's ALT and HBV DNA levels. Results Only one patient (1.1%) achieved spontaneous HBeAg seroconversion. Biochemical and symptomatic deterioration occurred before 6 months in 17 patients (18.9%) and 5 patients, respectively. High ALT and HBV DNA levels were both independent risk factors for biochemical deterioration. Of 15 patients with HBV DNA ≥5.1×107 IU/mL and ALT ≥5×ULN, biochemical deterioration occurred in 7 (46.7%), including 1 patient receiving liver transplantation due to liver failure. Conclusions Spontaneous HBeAg seroconversion in patients with HBeAg-positive CHB is rare within 6 months. Biochemical deterioration was common and may lead to liver failure. Immediate antiviral therapy should be considered, especially in patients with high ALT and HBV DNA levels in endemic areas of genotype C infection. |
| Databáze: | OpenAIRE |
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