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- Title
Delayed Clearance of Serum HBsAg in Compensated Cirrhosis B: Relation to Interferon Alpha Therapy and Disease Prognosis.
- Authors
Fattovich, Giovanna; Giustina, Giuliano; Sanchez-Tapias, José; Quero, Carlos; Mas, Anna; Olivotto, Pia Grazia; Solinas, Antonio; Almasio, Piero; Hadziyannis, Stephanos; Degos, Francoise; De Moura, Miguel Carneiro; Krogsgaard, Kim; Pantalena, Maurizio; Realdi, Giuseppe; Corrocher, Roberto; Schalm, Solko W.
- Abstract
Objective: The aim of this study was to evaluate the incidence, prognostic factors and clinical significance of delayed clearance of serum HBsAg in compensated cirrhosis B. Methods: This was a retrospective cohort study of 309 consecutive white patients with biopsy-proved compensated cirrhosis type B. Results: During a mean follow-up of 68 months, HBsAg loss occurred in 32 patients, including 16 (8 %) of 196 untreated patients (mean annual incidence 0.8%), 8 (10%) of 82 interferon (IFN) alpha-treated patients and eight patients who had been treated with other antivirals or steroids. The 5-yr probability of HBsAg loss was 4% and 16% for untreated and IFN-treated patients, respectively (<em>p</em> = 0.0001). Cox's regression analysis identified hepatitis B e antigen--positivity at entry as the sole independent prognostic factor for HBsAg loss. Of the 32 patients who lost HBsAg, one (3%) subsequently developed hepatocellular carcinoma (HCC) and died, whereas, among the patients who remained HBsAg-positive, 11% developed HCC and 20% had died. The probability of HCC appearance was lower (<em>p</em> = 0.0137) and survival was longer (<em>p</em> = 0.0006) in patients who cleared HBsAg compared with patients with HBsAg persistence. Conclusion: The incidence of HBsAg loss is about 0.8% in cirrhosis type B. Prognostic factors for clearance of HBsAg are initial HBeAg positivity and therapy with alpha interferon. Patients with cirrhosis type B, who lose HBsAg, have a low risk for liver cancer or liver-related death.
- Subjects
PROGNOSIS; HEPATITIS associated antigen; CIRRHOSIS of the liver; ANTIVIRAL agents; THERAPEUTICS
- Publication
American Journal of Gastroenterology (Springer Nature), 1998, Vol 93, Issue 6, p896
- ISSN
0002-9270
- Publication type
Article