Related Experiment Videos
HBeAg/anti-HBe seroconversion during and after protracted immunosuppressive treatment in type B chronic hepatitis
1Cátedra de Patología Médica III, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Argentina.
Insights
Hepatitis B e antigen (HBeAg) seroconversion to anti-HBe was studied in 77 patients. Immunosuppressive treatment for chronic hepatitis B reduced seroconversion rates, which increased upon drug withdrawal.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Hepatitis B e antigen (HBeAg) seroconversion is a key indicator of chronic hepatitis B (CHB) prognosis.
- Understanding seroconversion rates is crucial for managing CHB patients.
Purpose of the Study:
- To determine the seroconversion rate from HBeAg to anti-HBe in patients with chronic hepatitis B.
- To evaluate the impact of immunosuppressive treatment on HBeAg seroconversion.
Main Methods:
- Retrospective analysis of 77 HBeAg-positive chronic hepatitis patients (1971-1983).
- Assay of HBeAg and anti-HBe by RIA in stored sera.
- Correlation of serological markers with alanine aminotransferase (ALAT) levels.
- Calculation of linearized seroconversion rate (percent per patient-year).
Main Results:
- Seroconversion rates were 9.6% in chronic persistent hepatitis (CPH) and 8.8% in untreated chronic active hepatitis (CAH).
- Immunosuppressive treatment in CAH patients resulted in a significantly lower seroconversion rate (1.1%).
- Treatment withdrawal in CAH patients increased the seroconversion rate to 28.7%.
- Seroconverted patients had significantly lower ALAT levels than non-seroconverted patients.
Conclusions:
- Immunosuppressive therapy may delay HBeAg seroconversion in chronic hepatitis B.
- Withdrawal of immunosuppressive drugs can enhance seroconversion rates in CAH.
- Protracted use of immunosuppressants in CHB is cautioned against due to delayed seroconversion and potential side effects.
Abstract:
Seventy-seven consecutive HBeAg-positive chronic hepatitis patients were studied from 1971 to 1983 to establish the seroconversion rate in the e system. Patients with less than a year of follow-up were not included in the study. Fifty-six patients with chronic active hepatitis (CAH) received immunosuppressive treatment (corticosteroids combined with azathioprine). The remaining twenty-one patients received no treatment, nine of them with chronic persistent hepatitis (CPH) and 12 with CAH. A retrospective study was performed with stored sera samples: HBeAg and anti-HBe were determined by RIA, and results were correlated with alanine aminotransferase (ALAT) levels in the same samples. The linearized seroconversion rate from HBeAg to anti-HBe was expressed as percent per patient-year. It was 9.6% in CPH patients and 8.8% in CAH patients without treatment. In CAH patients under immunosuppressive drugs it was as low as 1.1% and increased to 28.7% when treatment was withdrawn. ALAT levels were significantly lower in total seroconverted patients when compared with nonseroconverted (NS) patients, but no difference was found between partial seroconverted (PS) and NS patients. The results suggest that although immunosuppressive drug withdrawal may enhance seroconversion rate in type B CAH, delayed seroconversion and reported side effects during treatment stand against protracted usage of these drugs.