Τίτλος:
Significance of liver histology in HBsAg-positive, IgM anti-HBc-negative acute hepatitis B virus-related hepatitis
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Aims: The natural course of HBsAg-positive, IgM anti-HBc-negative acute hepatitis B virus (HBV)-related hepatitis is unclear. The aim of this study was to evaluate the prognostic significance of histological features and hepatic expression of HBV antigens in such patients. Methods and results: Fifty patients with HBsAg-positive, IgM anti-HBc-negative acute hepatitis B who underwent liver biopsy during the acute hepatitis episode were studied [HBeAg seroconversion (n=16), persistently positive for HBeAg (n=9), and persistently negative for HBeAg (n=25)]. Twenty-six cases had features of typical acute hepatitis only (group A), and 24 cases had changes suggesting pre-existing chronic hepatitis (group B). HBcAg and/or HBsAg immunoreactivity was detected less frequently in group A than in group B (31% versus 79%, P=0.01). HBsAg clearance was observed in 24% of patients, almost exclusively in cases with HBeAg seroconversion. HBsAg loss was significantly more frequent in group A than in group B (52% versus 0%, P<0.001), and in cases without rather than with immunohistochemical expression of HBV antigens (55% versus 0%, P<0.001). In group A, HBsAg clearance was observed in 80%, 54% and 0% of patients with mild, moderate or severe acute hepatitis, respectively (P=0.034). Conclusions: Histological information is very important for the prognosis of HBsAg-positive, IgM anti-HBc-negative acute hepatitis B. HBeAg seroconversion with underlying typical acute hepatitis changes of mild to moderate severity without hepatic expression of HBV antigens strongly predicts subsequent HBsAg loss. © 2012 Blackwell Publishing Limited..
Συγγραφείς:
Delladetsima, I.
Papatheodoridis, G.V.
Tiniakos, D.G.
Hatzakis, A.
Tassopoulos, N.C.
Περιοδικό:
Diagnostic Histopathology
Λέξεις-κλειδιά:
hepatitis B core antigen; hepatitis B surface antigen; immunoglobulin M, acute hepatitis; adult; antigen expression; article; clinical article; clinical feature; disease severity; female; hepatitis B; human; human tissue; immunohistochemistry; immunoreactivity; liver biopsy; liver histology; male; predictive value; priority journal; prognosis; seroconversion; serodiagnosis, Acute Disease; Adolescent; Adult; Aged; Female; Hepatitis B; Hepatitis B Antibodies; Hepatitis B Core Antigens; Hepatitis B e Antigens; Hepatitis B Surface Antigens; Humans; Immunoglobulin M; Immunohistochemistry; Liver; Male; Middle Aged; Prognosis; Young Adult, Hepatitis B virus
DOI:
10.1111/j.1365-2559.2012.04294.x
