The prognosis of biopsy-proven asymptomatic HBsAg carrier.

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The prognosis of asymptomatic HBsAg carriers biopsy-proven to have no overt liver diseases was studied.<BR>Eighty three asymptomatic HBsAg carriers had been examined for liver function tests, circulatory HBsAg (RPHA), HBeAg and anti-HBe (RIA) periodically over a period of 12 to 122 months (mean 46 months).<BR>Of 30 cases positive for HBeAg on the first investigation, 14 (male 12, female 2) had developed overt hepatitis during follow-up period. In these 14 cases, liver function tests had returned to normal in 5 cases (male 3, female 2) who became negative for both HBeAg/anti-HBe (1 case) or who had seroconversion from HBeAg to anti-HBe (4 cases) subsequent to development of hepatitis. Whereas in 6 cases with sustaining HBeAg the serum transaminase levels had continued to be abnormally high. Repeat liver biopsies were done in 11 of these 14 cases. Six cases with persistent HBeAg developed chronic active hepatitis in 4 and liver cirrhosis in 1. In contrast, 3 of 4 seroconverted cases revealed an improvement from chronic active hepatitis to chronic persistent hepatitis in 2 male cases and to non specific reactive hepatitis in 1 female case. None of 50 cases positive for anti-HBe on the first investigation developed overt liver diseaes during the follow-up period.<BR>These results indicate that asymptomatic HBsAg carriers have a potential risk to develope overt liver diseases exclusively in cases persistently positive for HBeAg, but seroconversion from HBeAg to anti-HBe results in the regression from active to inactive liver disease. Some of them seroconvert from HBeAg to anti-HBe subsequent to the developement of liver diseases.
社団法人日本肝臓学会の論文

The prognosis of biopsy-proven asymptomatic HBsAg carrier.

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