Epidemiology

Long-term hepatitis B outlook often good

Last Updated: 2008-01-18 17:15:14 -0400 (Reuters Health)

NEW YORK (Reuters Health) - The majority of Caucasian patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis become inactive carriers over time, Italian researchers report.

In the January issue of Gut, Dr. Giovanna Fattovich of the University of Verona and colleagues note that studies conducted in Asian populations suggest high liver-associated morbidity and mortality in chronic hepatitis B patients, and thus further evaluation of the long-term outlook in Caucasians is required.

To do so, the researchers examined data on 70 patients with HBeAg-positive hepatitis B who were followed for a median of 25 years.

In all, 61 patients (87%) underwent spontaneous HBeAg seroconversion. During a median of 22.8 years after seroconversion, 40 (66%) became inactive carriers.

Liver-related deaths occurred in 11 patients, 5 due to hepatocellular carcinoma and 6 because of liver failure.

Overall, 50 patients were alive at the end of follow-up and the cumulative probability of survival was 90% at 10 years and 86% at 25 years. The 25-year probability of survival was 95% in inactive carriers, 50% in patients with HBeAg-negative hepatitis or HBeAg reversion, and 40% in those who were persistently HBeAg positive.

Summing up, Dr Fattovich told Reuters Health that "most patients with HBeAg seroconversion became inactive carriers with a very good prognosis."

The risk of liver-related mortality, she added, "is strongly related to sustained disease activity and an ongoing high level of hepatitis B virus replication, independently of HBeAg status."

Gut 2008;57:84-89.