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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.

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Serum transferrin as liver fibrosis biomarkerin patients with chronic hepatitis B Hyo Jung Cho, Soon Sun Kim, Seun Joo Ahn, Joo Han Park, Dong Joon Kim, Young Bae Kim, Sung Won Cho, Jae Youn Cheong pp.347-354

Is it necessary to delay antiviral therapy for 3-6 months to anticipate HBeAg seroconversion in patients with HBeAg-positive chronic hepatitis B in endemic areas of HBV genotype C? Byung-Cheol Song, Yoo-Kyung Cho, Hyeyoung Jwa, Eun Kwang Choi, Heung Up Kim, Hyun Joo Song, Soo-Young Na, Sun-Jin Boo, Seung Uk Jeong pp.355-360

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참고문헌 (37건) : 자료제공( 네이버학술정보 )

참고문헌 목록에 대한 테이블로 번호, 참고문헌, 국회도서관 소장유무로 구성되어 있습니다.
번호 참고문헌 국회도서관 소장유무
1 Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. 네이버 미소장
2 KASL Clinical Practice Guidelines: Management of chronic hepatitis B 네이버 미소장
3 EASL clinical practice guidelines: Management of chronic hepatitis B virus infection. 네이버 미소장
4 Chronic hepatitis B 네이버 미소장
5 Liaw YF, Kao JH, Piratvisuth T, Chan HLY, Chin R, Liu C, et al. Asian- Pacific consensus statement on the management of chronic hepatitis B: a 2012 update. Hepatol Int 2012;6:531-561. 미소장
6 Long-term treatment with entecavir induces reversal of advanced fibrosis or cirrhosis in patients with chronic hepatitis B. 네이버 미소장
7 Long‐term entecavir therapy results in the reversal of fibrosis/cirrhosis and continued histological improvement in patients with chronic hepatitis B 네이버 미소장
8 Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: a 5-year open-label follow-up study 네이버 미소장
9 Long-term entecavir treatment reduces hepatocellular carcinoma incidence in patients with hepatitis B virus infection. 네이버 미소장
10 Lamivudine for Patients with Chronic Hepatitis B and Advanced Liver Disease 네이버 미소장
11 Long-term entecavir treatment reduces hepatocellular carcinoma incidence in patients with hepatitis B virus infection. 네이버 미소장
12 Entecavir treatment reduces hepatic events and deaths in chronic hepatitis B patients with liver cirrhosis. 네이버 미소장
13 Clinical, virologic and histologic outcome following seroconversion from HBeAg to anti-HBe in chronic hepatitis type B. 네이버 미소장
14 Spontaneous hepatitis B e antigen to antibody seroconversion and reversion in Chinese patients with chronic hepatitis B virus infection. 네이버 미소장
15 Hepatitis B virus genotype B is associated with earlier HBeAg seroconversion compared with hepatitis B virus genotype C 네이버 미소장
16 Genotype C hepatitis B virus infection is associated with a higher risk of reactivation of hepatitis B and progression to cirrhosis than genotype B: A longitudinal study of hepatitis B e antigen-positive patients with normal aminotransferase levels at baseline 네이버 미소장
17 A large population study of spontaneous HBeAg seroconversion and acute exacerbation of chronic hepatitis B infection: implications for antiviral therapy. 네이버 미소장
18 Predictive Factors for Early HBeAg Seroconversion in Acute Exacerbation of Patients With HBeAg-Positive Chronic Hepatitis B 네이버 미소장
19 Hepatitis B virus genotypes and spontaneous hepatitis B e antigen seroconversion in Taiwanese hepatitis B carriers 네이버 미소장
20 Clinical and histological events preceding hepatitis B e antigen seroconversion in chronic type B hepatitis. 네이버 미소장
21 Mortality, Liver Transplantation, and Hepatocellular Carcinoma Among Patients With Chronic Hepatitis B Treated With Entecavir vs Lamivudine 네이버 미소장
22 Hsu YS, Chien RN, Yeh CT, Sheen IS, Chiou HY, Chu CM, et al. Longterm outcome after spontaneous HBeAg seroconversion in patients with chronic hepatitis B. Hepatology 2002;35:1522-1527. 미소장
23 Sustained disease remission after spontaneous HBeAg seroconversion is associated with reduction in fibrosis progression in chronic hepatitis B Chinese patients 네이버 미소장
24 Clearance of Hepatitis B e Antigen in Patients With Chronic Hepatitis B and Genotypes A, B, C, D, and F 네이버 미소장
25 Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the study of the liver (APASL). 네이버 미소장
26 McMahon BJ, Holck P, Bulkow L, Snowball M. Serologic and clinical outcomes of 1536 Alaska Natives chronically infected with hepatitis B virus. Ann Intern Med 2001;135:759-768. 미소장
27 Classifying hepatitis B virus genotypes. 네이버 미소장
28 Hepatitis B virus genotypes in Korea: an endemic area of hepatitis B virus infection. 네이버 미소장
29 Hepatitis B virus genotype C prevails among chronic carriers of the virus in Korea. 소장
30 Intrahepatic distribution of hepatitis B surface and core antigens in chronic hepatitis B virus infection 네이버 미소장
31 Tsai SL, Chen PJ, Lai MY, Yang PM, Sung JL, Huang JH, et al. Acute exacerbations of chronic type B hepatitis are accompanied by increased T cell responses to hepatitis B core and e antigens. Implications for hepatitis B e antigen seroconversion. J Clin Invest 1992;89:87-96. 미소장
32 Yoon JH, Rhee PL, Lee HS, Kim CY. Spontaneous HBeAg clearance rate and its affecting factors inpatients with chronic hepatitis B in Korea. Korean J Gastroenterol 1992;24:1313-1319. 미소장
33 Hepatic decompensation associated with hepatitis B e antigen clearance in chronic type B hepatitis. 네이버 미소장
34 Spontaneous reactivation of chronic hepatitis B virus infection. 네이버 미소장
35 Acute exacerbations in Chinese patients with chronic hepatitis B virus (HBV) infection: Incidence, predisposing factors and etiology 네이버 미소장
36 Hepatitis B Virus DNA Level Predicts Hepatic Decompensation in Patients With Acute Exacerbation of Chronic Hepatitis B 네이버 미소장
37 Predictive Factors for Reactivation of Hepatitis B Following Hepatitis B e Antigen Seroconversion in Chronic Hepatitis B 네이버 미소장

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