Predictors of reactivation of Hepatitis B following Hepatitis B e antigen seroconversion in chronic Hepatitis B have rarely been reported before and deserve further study.
Drs Chia-Ming Chu and Yun-Fan Liaw from Taiwan studied a total of 133 Hepatitis B e antigen-positive asymptomatic carriers who have undergone Hepatitis B e antigen seroconversion.
Reactivation of Hepatitis B was defined as elevation of alanine aminotransferase 2 times upper normal limit accompanied by serum Hepatitis B virus DNA detectable by hybridization assays.
|Reactivation of Hep B occurred at 3% per year|
The team evaluated 75 men and 58 women.
The mean age at entry was 28 years, of which 108 subjects had genotype B, and 25 had genotype C.
The maximal alanine aminotransferase levels during the Hepatitis B e antigen-positive phase were less than 2, 2 to 5, and 5 times the upper normal limit in 49, 40, and 44 subjects, respectively.
The researchers found that Hepatitis B e antigen seroconversion occurred after a mean follow-up of 5 years.
During a mean follow-up of 6 years following Hepatitis B e antigen seroconversion, reactivation of Hepatitis B occurred in 26 patients at 3% per year.
Multivariate analyses demonstrated that reactivation of Hepatitis B correlated significantly with genotype C, and male sex.
Alanine aminotransferase levels more than 5 times the upper normal limit during the Hepatitis B e antigen-positive phase was associated with reactivation of Hepatitis B.
In addition, the team noted that age at Hepatitis B e antigen seroconversion at 40 years was associated with reactivation of Hepatitis B.
Dr Chus' team concluded, "At baseline, genotype C and male sex are independent factors predictive of reactivation of Hepatitis B."
"Additionally, the likelihood of reactivation of Hepatitis B is increased if more rigorous immune-mediated hepatocytolysis or more prolonged immune clearance phase is necessary to eliminate the virus."