engleski

The prognosis of Hepatitis B virus chronic hepatitis in patients which were not treated with antiviral therapy

Aim: We decided to find out the natural history of our patients with HBV chronic hepatitis in which cases alcoholics and drug-addicts were excluded and who were never treated with any kind of antiviral therapy. Methods: We have analysed a group of 52 HBs Ag positive patients with histologically proven chronic B hepatitis: 18 (34.6%) cirrhosis (CH), 16 (37%) chronic active (CAH) and 12 (23%) chronic persistent (CPH), 6 (11.5%) of them had normal (N) histology. We followed them up for 5 years. In the sera of all our patients we determined and prospectively examined markers of viral replications: HBV DNA, HBeAg, anti HBcIgM as well as HBsAg, anti HBs, anti HBe, anti HBcIgG, anti HCV, anti D, AST, ALT, GGT. Results: The replication tests were positive in 44.23% among all 52 patientes, and most of them had liver cirrhosis, 14 (60.8%). Among the patients with HBV DNA positive, 17 (73.9%) were HBeAg positive but 6 (26.0%) were anti HBe positive. Anti HBc IgM antibodies were positive in 52.1% patients with HBV replications markers, AST, ALT were two times higher than normal in the all analysed patients. In 52 patients that we had investigated we did 16 control liver biopses after 5 years of following up. 3 patients with CPH developed CH, 4 with CAH also developed CH, 1 patient with CH developed HCC, and the others remained CH. 3 (5.7%) patients died after the investigation, one with HCC and two with CH. Conclusion: After 5 years of continous follow-up of our patients with HBV chronic liver diseases we found out that there was not spontaneous seroconversion of HBsAg and HBeAg and the serum HBV DNA was still positive. All the cirrhotic patients remained in Child-Pugh A degree and percentage of mortality was low (5.7%). With our investigation and results obtained we believe that we have contributed to the recent issues about necessity of producing new and more efficient drugs for HBV hepatitis.

Hepatitis B virus; Chronic hepatitis; Natural history

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