Article: Sustained disease remission after spontaneous HBeAg seroconversion is associated with reduction in fibrosis progression in chronic hepatitis B Chinese patients

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TitleSustained disease remission after spontaneous HBeAg seroconversion is associated with reduction in fibrosis progression in chronic hepatitis B Chinese patients
AuthorsHui, CK2
Leung, N6
Shek, TWH5
Yao, H3
Lee, WK1
Lai, JY3
Lai, ST3
Wong, WM4
Lai, LSW7
Poon, RTP2
Lo, CM2
Fan, ST2
Lau, GKK2
Issue Date2007
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/
CitationHepatology, 2007, v. 46 n. 3, p. 690-698 [How to Cite?]
DOI: http://dx.doi.org/10.1002/hep.21758
AbstractRecently, controversies have arisen about whether hepatitis B e antigen (HBeAg) seroconversion can result in regression of fibrosis, thus improving the clinical outcome of Chinese patients with chronic hepatitis B. In this study, we determined if spontaneous HBeAg seroconversion is associated with regression of fibrosis in Chinese chronic hepatitis B patients. We evaluated the histology of liver samples from 128 HBeAg-positive treatment-naive Chinese patients who had undergone 2 liver biopsies over the years. Regression of fibrosis was defined as a decrease in fibrosis stage of at least 1 point. Sustained disease remission was defined as HBeAg seroconversion and hepatitis B virus (HBV) DNA < 10 4 copies/ml at follow-up liver biopsy. The mean duration (± standard error of the mean) between the initial and follow-up liver biopsies was 43.9 ± 3.4 months. Regression of fibrosis was higher in patients with sustained disease remission (5 of 13 [38.5%] versus 22 of 115 [19.1%], P < 0.00005), patients who were younger (20-29 years old) at initial liver biopsy (17 of 54 [31.5%] versus 10 of 74 [13.5%], P = 0.0004), and patients with genotype B (17of 43 [39.5%] versus 10 of 85 [11.8%], P = 0.004). On multivariate analysis, sustained disease remission (relative risk [RR] 3.00, 95% confidence interval [95% CI] 1.29-7.01, P = 0.01) and being 20-29 years old at initial liver biopsy (RR 2.94, 95% CI 1.01-8.62, P = 0.04) were independently associated with regression of fibrosis. The rate of fibrosis progression was lower in patients with sustained disease remission than in those who remained HBeAg positive (median 0 fibrosis units/year, range -2.00 to -0.70 fibrosis units/year, versus median 0.51 fibrosis units/year, range 0 to +2.03 fibrosis units/year, P = 0.02). Conclusion: Spontaneous sustained remission of disease is associated not only with little progression of fibrosis but also with regression of fibrosis. Copyright © 2007 by the American Association for the Study of Liver Diseases.
ISSN0270-9139
2011 Impact Factor: 11.665
2011 SCImago Journal Rankings: 1.278
DOIhttp://dx.doi.org/10.1002/hep.21758
ISI Accession Number IDWOS:000249191600012
ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorHui, CK
dc.contributor.authorLeung, N
dc.contributor.authorShek, TWH
dc.contributor.authorYao, H
dc.contributor.authorLee, WK
dc.contributor.authorLai, JY
dc.contributor.authorLai, ST
dc.contributor.authorWong, WM
dc.contributor.authorLai, LSW
dc.contributor.authorPoon, RTP
dc.contributor.authorLo, CM
dc.contributor.authorFan, ST
dc.contributor.authorLau, GKK
dc.date.accessioned2010-09-06T08:43:53Z
dc.date.available2010-09-06T08:43:53Z
dc.date.issued2007
dc.description.abstractRecently, controversies have arisen about whether hepatitis B e antigen (HBeAg) seroconversion can result in regression of fibrosis, thus improving the clinical outcome of Chinese patients with chronic hepatitis B. In this study, we determined if spontaneous HBeAg seroconversion is associated with regression of fibrosis in Chinese chronic hepatitis B patients. We evaluated the histology of liver samples from 128 HBeAg-positive treatment-naive Chinese patients who had undergone 2 liver biopsies over the years. Regression of fibrosis was defined as a decrease in fibrosis stage of at least 1 point. Sustained disease remission was defined as HBeAg seroconversion and hepatitis B virus (HBV) DNA < 10 4 copies/ml at follow-up liver biopsy. The mean duration (± standard error of the mean) between the initial and follow-up liver biopsies was 43.9 ± 3.4 months. Regression of fibrosis was higher in patients with sustained disease remission (5 of 13 [38.5%] versus 22 of 115 [19.1%], P < 0.00005), patients who were younger (20-29 years old) at initial liver biopsy (17 of 54 [31.5%] versus 10 of 74 [13.5%], P = 0.0004), and patients with genotype B (17of 43 [39.5%] versus 10 of 85 [11.8%], P = 0.004). On multivariate analysis, sustained disease remission (relative risk [RR] 3.00, 95% confidence interval [95% CI] 1.29-7.01, P = 0.01) and being 20-29 years old at initial liver biopsy (RR 2.94, 95% CI 1.01-8.62, P = 0.04) were independently associated with regression of fibrosis. The rate of fibrosis progression was lower in patients with sustained disease remission than in those who remained HBeAg positive (median 0 fibrosis units/year, range -2.00 to -0.70 fibrosis units/year, versus median 0.51 fibrosis units/year, range 0 to +2.03 fibrosis units/year, P = 0.02). Conclusion: Spontaneous sustained remission of disease is associated not only with little progression of fibrosis but also with regression of fibrosis. Copyright © 2007 by the American Association for the Study of Liver Diseases.
dc.description.natureLink_to_subscribed_fulltext
dc.identifier.citationHepatology, 2007, v. 46 n. 3, p. 690-698 [How to Cite?]
DOI: http://dx.doi.org/10.1002/hep.21758
dc.identifier.doihttp://dx.doi.org/10.1002/hep.21758
dc.identifier.epage698
dc.identifier.hkuros139483
dc.identifier.isiWOS:000249191600012
dc.identifier.issn0270-9139
2011 Impact Factor: 11.665
2011 SCImago Journal Rankings: 1.278
dc.identifier.issue3
dc.identifier.openurl
dc.identifier.pmid17680649
dc.identifier.scopuseid_2-s2.0-34548806374
dc.identifier.spage690
dc.identifier.urihttp://hdl.handle.net/10722/83677
dc.identifier.volume46
dc.languageeng
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/
dc.publisher.placeUnited States
dc.relation.ispartofHepatology
dc.relation.referencesReferences in Scopus
dc.rightsHepatology. Copyright © John Wiley & Sons, Inc.
dc.titleSustained disease remission after spontaneous HBeAg seroconversion is associated with reduction in fibrosis progression in chronic hepatitis B Chinese patients
dc.typeArticle
Author Affiliations
  1. Tuen Mun Hospital
  2. The University of Hong Kong
  3. Princess Margaret Hospital Hong Kong
  4. St. Paul's Hospital Hong Kong
  5. Queen Mary Hospital Hong Kong
  6. Alice Ho Miu Ling Nethersole Hospital
  7. Caritas Medical Centre Hong Kong