 |
 |
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1 February 1993 | Volume 118 Issue 3 | Pages 191-194
Objective: To assess the long-term outcome in hepatitis B surface antigen (HBsAg) carriers who have normal liver function tests, focusing on survival and the development of severe liver disease and hepatocellular carcinoma.
Design: Cohort study with a mean follow-up of 130 months.
Setting: Liver clinic of a referral center.
Patients: Ninety-two HBsAg-positive blood donors with normal liver function tests.
Measurements: Histologic evaluation of liver specimens at baseline; clinical, biochemical, and serologic follow-up; and repeat liver biopsy if clinically indicated or after 10 years of follow-up.
Results: At baseline, 69 subjects had normal histologic findings or only minor abnormalities, 18 had chronic persistent hepatitis, and 5 had mild chronic active hepatitis. Serum enzyme levels remained normal in 58 of 68 patients who had regular follow-up. Three patients had biochemical changes consistent with hepatitis B virus (HBV) infection; in one of these patients, a later histologic evaluation showed progression to chronic active hepatitis. One patient developed alcoholic cirrhosis. Six other patients had mild or transient transaminase elevations, with no evidence of HBV replication, hepatitis D virus infection, hepatitis C virus (HCV) infection, or histologic deterioration. Liver histologic findings also remained unchanged in 21 patients who showed no biochemical changes during 10 years of follow-up and consented to have repeated liver biopsy. Ten patients showed loss of HBsAg; 2 of these patients acquired antibody to hepatitis B surface antigen (anti-HBs). All patients who did not have regular follow-up, except 1, were interviewed by telephone during 1990: All denied having liver disease. No patients developed hepatocellular carcinoma.
Conclusions: Italian HBsAg carriers with initially normal liver function tests have an excellent prognosis: Delta superinfection is infrequent and the risk for developing hepatocellular carcinoma is low.
Author and Article Information
From Istituto di Medicina Interna, University of Milan, Milan, Italy.
ARTICLE
The Natural History of Asymptomatic Hepatitis B Surface Antigen Carriers
Requests for Reprints: Roberto de Franchis, MD, Istituto di Medicina Interna, Via Pace 9, 20122 Milano, Italy.
This article has been cited by other articles:
|
|
 |
|
  G Fattovich, N Olivari, M Pasino, M D'Onofrio, E Martone, and F Donato Long-term outcome of chronic hepatitis B in Caucasian patients: mortality after 25 years Gut, January 1, 2008; 57(1): 84 - 90. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. T Goldstein, F. Zhou, S. C Hadler, B. P Bell, E. E Mast, and H. S Margolis A mathematical model to estimate global hepatitis B disease burden and vaccination impact Int. J. Epidemiol., December 1, 2005; 34(6): 1329 - 1339. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M Sherman Predicting survival in hepatitis B Gut, November 1, 2005; 54(11): 1521 - 1523. [Full Text] [PDF]
|
|
|
|
 |
|
 D. Ganem and A. M. Prince Hepatitis B Virus Infection -- Natural History and Clinical Consequences N. Engl. J. Med., March 11, 2004; 350(11): 1118 - 1129. [Full Text] [PDF]
|
|
|
|
 |
|
 B. J. McMahon, P. Holck, L. Bulkow, and M. Snowball Serologic and Clinical Outcomes of 1536 Alaska Natives Chronically Infected with Hepatitis B Virus Ann Intern Med, November 6, 2001; 135(9): 759 - 768. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Espinosa, A. Martin-Malo, M. A. A. de Lara, and P. Aljama Risk of death and liver cirrhosis in anti-HCV-positive long-term haemodialysis patients Nephrol. Dial. Transplant., August 1, 2001; 16(8): 1669 - 1674. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. R. Dufour, J. A. Lott, F. S. Nolte, D. R. Gretch, R. S. Koff, and L. B. Seeff Diagnosis and Monitoring of Hepatic Injury. II. Recommendations for Use of Laboratory Tests in Screening, Diagnosis, and Monitoring Clin. Chem., December 1, 2000; 46(12): 2050 - 2068. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F ter Borg, F J W ten Kate, H T M Cuypers, A Leentvaar-Kuijpers, J Oosting, P M E Wertheim-Van Dillen, P Honkoop, M C Rasch, R A de Man, J van Hattum, et al. A survey of liver pathology in needle biopsies from HBsAg and anti-HBe positive individuals J. Clin. Pathol., July 1, 2000; 53(7): 541 - 548. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. Fendrick, J. H. Lee, C. LaBarge, and H. A. Glick Clinical and Economic Impact of a Combination Haemophilus influenzae and Hepatitis B Vaccine: Estimating Cost-effectiveness Using Decision Analysis Arch Pediatr Adolesc Med, February 1, 1999; 153(2): 126 - 136. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Gitlin Hepatitis B: diagnosis, prevention, and treatment Clin. Chem., August 1, 1997; 43(8): 1500 - 1506. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Collazos, I. F. Ciernik, H. Tsukuma, T. Hiyama, and A. Inoue Risk Factors for Hepatocellular Carcinoma in Patients with Chronic Liver Diseases N. Engl. J. Med., December 16, 1993; 329(25): 1896 - 1898. [Full Text]
|
|
Article
