Effect of Immunosuppressive Therapy on HBsAg-Positive Chronic Active Hepatitis in Relation to Presence or Absence of HBeAg and Anti-HBe

Authors

  • Evangelista Sagnelli,

    Corresponding author
    1. Clinic of Infectious Diseases and Department of Clinical Virology, First School of Medicine, University of Naples (and) “D. Cotugno” Hospital for Infectious Diseases, 80135 Naples, Italy
    • Evangelista Sagnelli, M.D., Clinic o Infectious Diseases, First School of Medicine, University of Naples Via D. Cotugno 1, 80135 Naples, Italy.
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  • Felice Piccinino,

    1. Clinic of Infectious Diseases and Department of Clinical Virology, First School of Medicine, University of Naples (and) “D. Cotugno” Hospital for Infectious Diseases, 80135 Naples, Italy
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  • Giuseppe Manzillo,

    1. Clinic of Infectious Diseases and Department of Clinical Virology, First School of Medicine, University of Naples (and) “D. Cotugno” Hospital for Infectious Diseases, 80135 Naples, Italy
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  • Francesca M. Felaco,

    1. Clinic of Infectious Diseases and Department of Clinical Virology, First School of Medicine, University of Naples (and) “D. Cotugno” Hospital for Infectious Diseases, 80135 Naples, Italy
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  • Pietro Filippini,

    1. Clinic of Infectious Diseases and Department of Clinical Virology, First School of Medicine, University of Naples (and) “D. Cotugno” Hospital for Infectious Diseases, 80135 Naples, Italy
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  • Giuseppe Maio,

    1. Clinic of Infectious Diseases and Department of Clinical Virology, First School of Medicine, University of Naples (and) “D. Cotugno” Hospital for Infectious Diseases, 80135 Naples, Italy
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  • Giuseppe Pasquale,

    1. Clinic of Infectious Diseases and Department of Clinical Virology, First School of Medicine, University of Naples (and) “D. Cotugno” Hospital for Infectious Diseases, 80135 Naples, Italy
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  • Crescenzo M. Izzo

    1. Clinic of Infectious Diseases and Department of Clinical Virology, First School of Medicine, University of Naples (and) “D. Cotugno” Hospital for Infectious Diseases, 80135 Naples, Italy
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Abstract

Two hundred and four patients with biopsy-proven HBsAg-positive chronic active hepatitis were treated for at least 2 years with azathioprine, prednisolone or a combination of both, or were untreated. Prevalences of HBeAg, anti-HBe, and anti-HBc were 26, 58, and 100%, respectively.

Criteria for improvement or progression of disease were based on clinical, biochemical, and morphologic parameters. Prednisolone therapy and combination therapy did not modify the course of the disease in HBeAg-positive patients; azathioprine therapy may have been deleterious for these patients. Among HBeAg-negative patients, deterioration or death occurred more frequently in those who were untreated than in those who received the combination of azathioprine and prednisolone. Prednisolone therapy was of moderate effect, whereas azathioprine did not influence the outcome.

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