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The purposes of this study is to observe the changes of HBeAg/anti-HBe system and to predict the prognosis of patients with HBeAg positive chronic hepatitis. This study consists of ninety patients with HBeAg positive chronic hepatitis who were followed for two to ten years (mean 4.3 years). Diagnosis of liver disease was made according to the findings of liver biopsy and HBeAg and anti-HBe were determined by RIA method.<BR>Clearance of HBeAg was observed in 36 of 90 cases and appearance of anti-HBe in 18 of these 36 during observation period. Cumulative clearance rate of HBeAg at five years after observation was 45.2 percent. Furthermore, cumulative seroconversion rate from HBeAg to anti-HBe was 25.4 percent at five years. The clearance rate and seroconversion rate were higher in females, cases under 35 years old and cases with elevated serum level of GPT over 300 KU. Clearance of HBeAg was not shown in cases with lower level of GPT under 100 KU. HBeAg in chronic active hepatitis with bridging necrosis was cleared in early phase of this study. Many in cases with persistent positive HBeAg progressed to liver cirrhosis or hepatocellular carcinoma. However, some cases with bridging necrosis or lobular disorganization and/or with higher serum level of GPT over 100KU at least four times during this study, developed to liver cirrhosis or hepatocellullar carcinoma.<BR>These result led to conclude that clearance of HBeAg or seroconversion to anti-HBe did not always reflect good prognosis.
- 社団法人 日本肝臓学会の論文