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Immunosuppressive treatment of HBsAg-positive chronic liver disease: Significance of HBeAg

Authors

  • Ulrik Tage-Jensen,

    1. Medical Department B, Bispebjerg Hospital, Hvidovre Hospital, Copenhagen, Denmark
    2. Medical Department 2, Kommunehospitalet, Hvidovre Hospital, Copenhagen, Denmark
    3. Medical Department A and Department of Infectious Disease M, Rigshospitalet, Hvidovre Hospital, Copenhagen, Denmark
    4. Medical Department, Skt. Elisabeth Hospital, Hvidovre Hospital, Copenhagen, Denmark
    5. Division of Hepatology and Department of Pathology, Hvidovre Hospital, Copenhagen, Denmark
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  • Jan Aldershvile,

    1. Medical Department B, Bispebjerg Hospital, Hvidovre Hospital, Copenhagen, Denmark
    2. Medical Department 2, Kommunehospitalet, Hvidovre Hospital, Copenhagen, Denmark
    3. Medical Department A and Department of Infectious Disease M, Rigshospitalet, Hvidovre Hospital, Copenhagen, Denmark
    4. Medical Department, Skt. Elisabeth Hospital, Hvidovre Hospital, Copenhagen, Denmark
    5. Division of Hepatology and Department of Pathology, Hvidovre Hospital, Copenhagen, Denmark
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  • Poul Schlichting

    1. Medical Department B, Bispebjerg Hospital, Hvidovre Hospital, Copenhagen, Denmark
    2. Medical Department 2, Kommunehospitalet, Hvidovre Hospital, Copenhagen, Denmark
    3. Medical Department A and Department of Infectious Disease M, Rigshospitalet, Hvidovre Hospital, Copenhagen, Denmark
    4. Medical Department, Skt. Elisabeth Hospital, Hvidovre Hospital, Copenhagen, Denmark
    5. Division of Hepatology and Department of Pathology, Hvidovre Hospital, Copenhagen, Denmark
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  • Members of the group are: Mogens Bjørneboe; Per Christoffersen; Odd Dietrichson; Viggo Faber; Gerda Høybye; Finn Hardt; Mogens Hilden; Kurt Iversen; Ove Jessen; Erik Juhl; Jørgen Lindskov; Stig Munkgaard; Jens O. Nielsen; Svend Nørregaard; Hemming Poulsen; Hanne Prytz; Klaus Ramsøe; Leo Ranek; Vagn Reinicke; Poul Schlichting; Thorkild I. A. Sørensen; Ulrik Tage-Jensen; Age Chr. Thomsen; Niels Tygstrup; and Kjeld Winkler.

Abstract

In a randomized clinical trial in 148 patients of azathioprine vs. prednisone treatment of chronic aggressive hepatitis and/or nonalcoholic cirrhosis, 20 were HBsAg positive on entry. In this subgroup sequential serum samples were investigated for HBs and HBe markers by radioimmunoassay. At the time of evaluation, 13 patients were still alive; their median age was 53 years (25 to 72) and median follow-up time was 46 months (23 to 82).

Of 16 patients with cirrhosis, 5 of 7 with persistence of HBeAg died, compared with 2 of 9 with anti-HBe. In three patients with anti-HBe, HBeAg reappeared several times with simultaneous rise in transaminase values.

The overall survival was 65% after 5 years. The prognosis of HBsAg-positive chronic liver disease seemed to depend on the presence of cirrhosis and HBeAg rather than on improvement in biochemical activity during immunosuppressive treatment.

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