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[Long-term clinical observations of chronic active hepatitis HBsAg (+)]
H Cichoz-Lach1, J Daniluk, M Słomka
1Katedry i Kliniki Gastroenterologii AM, Lublinie.
Insights
Chronic active hepatitis B (HBsAg+) can progress to cirrhosis within years. Non-immunosuppressive therapies showed fewer cirrhosis cases compared to immunosuppressive treatments in clinical observation.
Area of Science:
- Hepatology
- Virology
- Clinical Medicine
Context:
- Observational study of 48 patients with chronic active hepatitis B (HBsAg+).
- Patients experienced viral hepatitis for an average of 1.5 years prior to chronic active hepatitis diagnosis.
- Follow-up period ranged from 3 to 18 years.
Purpose:
- To analyze the progression of chronic active hepatitis B to cirrhosis.
- To evaluate the impact of different treatment regimens on cirrhosis development.
- To determine the time course of cirrhosis development in HBsAg+ patients.
Summary:
- Cirrhosis developed in 52.1% of patients with chronic active hepatitis B.
- The average time from chronic active hepatitis diagnosis to cirrhosis was 3 years.
- Treatment with penicillamine and prednisone was associated with the highest incidence of cirrhosis (80%), followed by azathioprine and prednisone (48%). Non-immunosuppressive therapies resulted in the fewest cases.
Impact:
- Highlights the significant risk of cirrhosis in chronic active hepatitis B patients.
- Suggests that non-immunosuppressive therapies may be more effective in preventing cirrhosis progression.
- Provides crucial data for clinical decision-making in managing chronic active hepatitis B.
Abstract:
This paper presents results of 3-18 year clinical observation of 48 patients with chronic active hepatitis HBsAg (+). 40 patients had suffered viral hepatitis for a period from 6 months to 3 years (avg. 1.5 year) before chronic active hepatitis manifested. Cirrhosis hepatis was a consequence of chronic active hepatitis in 52.1%, chronic active hepatitis in 45.8%, and chronic persistence in 2.1% of cases, during observation period. The average transition time from chronic active hepatitis to cirrhosis was 3 years. 48% of cirrhosis hepatis occurred within 2 years starting from recognition of chronic active hepatitis and 80% within 5 years. Most cases of cirrhosis were recorded if patients had been treated with penicillamine and prednisone (80% of cases), then with azathioprine and prednisone (48% of cases), while the least with ++non-immunosuppressive therapy (penicillamine, isoprinosine or "+hepatic protectors").