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

TitleSustained disease remission after spontaneous HBeAg seroconversion is associated with reduction in fibrosis progression in chronic hepatitis B Chinese patients
Authors
Issue Date2007
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/
Citation
Hepatology, 2007, v. 46 n. 3, p. 690-698 How to Cite?
Abstract
Recently, 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.
Persistent Identifierhttp://hdl.handle.net/10722/83677
ISSN
2013 Impact Factor: 11.190
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorHui, CKen_HK
dc.contributor.authorLeung, Nen_HK
dc.contributor.authorShek, TWHen_HK
dc.contributor.authorYao, Hen_HK
dc.contributor.authorLee, WKen_HK
dc.contributor.authorLai, JYen_HK
dc.contributor.authorLai, STen_HK
dc.contributor.authorWong, WMen_HK
dc.contributor.authorLai, LSWen_HK
dc.contributor.authorPoon, RTPen_HK
dc.contributor.authorLo, CMen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorLau, GKKen_HK
dc.date.accessioned2010-09-06T08:43:53Z-
dc.date.available2010-09-06T08:43:53Z-
dc.date.issued2007en_HK
dc.identifier.citationHepatology, 2007, v. 46 n. 3, p. 690-698en_HK
dc.identifier.issn0270-9139en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83677-
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.en_HK
dc.languageengen_HK
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/en_HK
dc.relation.ispartofHepatologyen_HK
dc.rightsHepatology. Copyright © John Wiley & Sons, Inc.en_HK
dc.titleSustained disease remission after spontaneous HBeAg seroconversion is associated with reduction in fibrosis progression in chronic hepatitis B Chinese patientsen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0270-9139&volume=46&issue=3&spage=690&epage=698&date=2007&atitle=Sustained+disease+remission+after+spontaneous+HBeAg+seroconversion+is+associated+with+reduction+in+fibrosis+progression+in+chronic+hepatitis+B+Chinese+patientsen_HK
dc.identifier.emailPoon, RTP: poontp@hkucc.hku.hken_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.authorityPoon, RTP=rp00446en_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/hep.21758en_HK
dc.identifier.pmid17680649en_HK
dc.identifier.scopuseid_2-s2.0-34548806374en_HK
dc.identifier.hkuros139483en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-34548806374&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume46en_HK
dc.identifier.issue3en_HK
dc.identifier.spage690en_HK
dc.identifier.epage698en_HK
dc.identifier.isiWOS:000249191600012-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridHui, CK=35082057900en_HK
dc.identifier.scopusauthoridLeung, N=26643107200en_HK
dc.identifier.scopusauthoridShek, TWH=7005479861en_HK
dc.identifier.scopusauthoridYao, H=8103931800en_HK
dc.identifier.scopusauthoridLee, WK=21743375200en_HK
dc.identifier.scopusauthoridLai, JY=36017046500en_HK
dc.identifier.scopusauthoridLai, ST=7402937038en_HK
dc.identifier.scopusauthoridWong, WM=7403972413en_HK
dc.identifier.scopusauthoridLai, LSW=12769869000en_HK
dc.identifier.scopusauthoridPoon, RTP=7103097223en_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridLau, GKK=7102301257en_HK

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