Immunosuppressive therapy in chronic liver diseases of type B with special reference to its effects on HBeAg/anti-HBe systems in serum and HBcAg in the liver.

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Changes in HBeAg/anti-HBe systems in serum, HBcAg in liver tissue (indirect immunoperoxidase method) and liver histology were studied in 25 HBsAg positive patients of chronic liver diseases who received immunosuppressive therapy for 16.8 months in average (range: 5-74) and they were compared with those in 24 patients with HBsAg positive chronic liver diseases who did not receive therapy.<BR>In HBeAg positive cases, seroconversion from HBeAg to anti-HBe was found to occur in 4 out of 18 treated patients during the therapy or after withdrawal. HBcAg in the liver was increased in grade in 8 (44.4%) out of 18 treated patients, whereas in only 1 (5.3%) out of 19 untreated patients (p<0.01). However, no difference of histological outcome could be observed between treated and untreated groups.<BR>In anti-HBe positive cases (7 treated and 5 untreated), serum anti-HBe was persistently positive throughout the observation period in both groups and there was no case in treated group in whom tissue HBcAg became positive and liver histology became worsened.<BR>These results indicate that immunosuppressive therapy potentially enhance HBV replication in HBeAg positive patients and may reserved for anti-HBe positive patients with chronic liver diseases when indicated.
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